摘要:目的:研究高血压老年患者发生骨质疏松或骨量减低的危险因素.方法对1620例50岁以上高血压患者进行问卷调查和跟骨超声骨密度检查,收集服用钙通道阻滞剂(CCB)或钙离子拮抗剂(CA)等药物情况以及饮食嗜好和生活习惯等信息,采用χ2检验和多因素 Logistic回归分析,分析影响骨密度的危险因素.结果1620例高血压老年患者中,骨密度正常566例(34.9%)、骨量减低860例(53.1%)、骨质疏松194例(12.0%).服用CCB/CA、嗜好咖啡、可乐、巧克力以及吸烟的研究对象骨密度减低发生率较高(P 均<0.001);嗜好牛奶者的骨密度降低的发生率较低(P<0.001).骨量减低的多因素 Logistic 回归分析结果显示,长期服用 CCB/CA 的OR=59.36(95%CI:49.56~99.70)、嗜好咖啡OR=29.74(95%CI:15.70~59.40)、嗜好可乐OR=25.65(95%CI:12.86~53.28)、嗜好巧克力的OR=23.77(95%CI:12.00~53.15)、吸烟的OR=3.26(95%CI:1.95~5.95),嗜好牛奶对骨密度降低具有保护作用,OR=0.42(95%CI:0.21~0.83).结论高血压老年患者应该注意饮食的健康管理,服用钙离子拮抗剂或阻滞剂的患者,应同时监测骨密度的变化,预防骨量减低和骨质疏松.%Objectives To explore the risk factors of osteoporosis or osteopenia of elderly hypertensive pa-tients.Methods Questionnaire survey and ultrasound bone scanner via calcaneus was used to collected data of 1 620 elderly patients with hypertension,and the data collected including living habits,diet hobbies and the use of calcium channel blockers (CCB)or calcium antagonists (CA)and so on. Chi-square analysis and multivariate Logistic re-gression were used to analyze the data. Results 566 (34.9%)patients were with normal bone mineral density (BMD),860 (53.1%)were with osteopenia and 194 (12.0%)were with osteoporosis. The rates of low BMD were higher in groups of taking CCB or CA (OR=59.36,95%CI:49.56~99.70),and being like to drink coffee (OR=29.74,95%CI:15.70~59.40)and cola (OR=25.65,95% CI:12.86~53.28),eat chocolate (OR=23.77, 95%CI:12.00~53.15),and smoke (OR=3.26,95%CI:1.95~5.95),while the rate of low BMD was lower in group like to drink milk (OR=0.421,95% CI:0.213~0.834). Conclusions Attention of health manage-ment on diet should be paid for elderly hypertension patients,and routine monitoring of BMD is recommended for elderly hypertension patient using CCB/CA drugs to prevent low BMD and osteoporosis.