The Feature Of Ambulatory Blood Pressure Monitoring In Aged Hypertensives And The Value Of Rehabilitation Therapy To Plasma Endothelin

Objective: To evaluate the feature of ambulatory blood pressure monitoring (ABPM) in elderly hypertensives and rehabilitation therapy. .To investigate the relationship between plasma endothelin levels and the references of ambulatory blood monitoring.Methods : The noninvasive blood pressure recorder (producted by England) was used to carry out 24-hour ABPM in eighty elderly hypertensive patients who were untreated at the time of execution of ABP monitoring. Day and night have been arbitrarily defined through fixed fired time intervals. Blood pressure (BP) readings were obtained automatically at 15-minute in tervals at daytime and 30-minute intervals at nighttime. The parameters analyzed were 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP), mean daytime SBP and DBP, mean nighttime SBP and DBP, 24-hour mean BP and 24-hour mean PP, blood pressure load and fluctuation of 24-hour BP. 38 patients with essential hypertension(stage I and II )were divided into two groups.One group for training therapy ,another for rehabilization therapy,Radio-immunoassy was used for the determination of plasma endothelin levels.Result: 24-hour SBP and DBP, daytime SBP and DBP, nighttime SBP and DBP and blood pressure load in the eightyelderly hypertensives were significantly higher than normal references.Plasma endothelin levels were normal in the patients with essential hypertension(stage I and II ) and dipper group,but were higher in the nondipper group(P <'0.01).Plasma endothelin levels in the nondipper group significantly correlated with 24-hambulatory blood pressure especially with nondipper group(P < 0.001).Rehabilization therapy can reduce significantly the levels of blood pressure,and body weight and BMI. the therapys can decrease the levels of plasma endothelin.Conclusion: The rehabilitative therapy shoud be taked in the first treatement stage.Elevation of plasma endothelin level is related with loss of diurnal rhythm of blood pressure in essential hypertension with complication.Endothelin is likely to be involved in the elevation of noctuenal blood pressure.The parameters of ABPM are of great importance in diagnosing, treating essential hypertension and evaluating the effect of rehabilitation therapy. They are also of great prognostic significance in current evidence and clinic implications.