Essential Hypertension In Patients With Abnormal Circadian Rhythm Of Blood Pressure On Left Ventricular Hypertrophy And Carotid Atherosclerosis Of The Impact Of Clinical Research

Objection:To investigate the impactof essential hypertension in patients with abnormal circadian rhythm of blood pressure on left ventricular hypertrophy and carotid atherosclerosis.Method:Select patients with essential hypertension in 64 cases, of which 37 cases of male, female 27 cases, aged 42 to 82 years old, the average age (65.56±9.25) years old; Application of 24-hour ambulatory blood pressure monitoring (ABPM) to monitor the circadian rhythm of blood pressure,according to the blood pressure parameters to calculate the rate of decline in nocturnal blood pressure were divided into three groups:dippers group (n = 24), non-dipper group (n = 29) and extreme-dipper group (n = 11) .All patients were performed color doppler ultrasound.The carotid artery intima-media thickness (IMT),interventficular septal thickness(IVST),1eft ventricular end diastolic dimension(LVDd) and 1eft ventricular posterior wall thickness(LVPWT) were recorded,and the1eft ventricular mass(LVM) and the 1eft ventricular mass index(LVMI)were calculated according to the Devereux formula; Will dipper group as a control group,to compare the differences in ambulatory blood pressure parameters and left ventricular mass index (LVMI)and carotid artery intimal medial thickness (IMT ) the relationship between non-dipper group,extreme-dipper group and dipper group.Result:1,Observed in patients with essential hypertension,the average age was significantly higher in extreme-dipper group than those in dipper group (70.64±5.82 vs 64.83±9.73 ,P <0.05).2,The rate of decline in nocturnal blood pressure of non-dipper group was significantly lower than that of dipper group,the levels of nSBP of non-dipper group was significantly higher than that of dipper group; the rate of decline in nocturnal blood pressure of extreme-dipper group was significantly higher than that of dipper group, the levels of dSBP,dDBP of extreme-dipper group was significantly higher than that of dipper group, the levels of nSBP,nDBP of extreme-dipper group was significantly lower than that of dipper group (P <0.05).3,The levels of IVST,LVPwT,LVM,LVMI,IMT of non-dipper group and extreme-dipper group were significantly higher than that of dipper group (P <0.05),analysis of covariance correction by age, gender, body mass index, smoking, blood sugar, blood lipid levels, and other possible cardiovascular remodeling, there are still significant difference (P <0.05); The detection rate of LVH and carotid artery plaque of non-dipper group and extreme-dipper group was significantly higher than that of dipper group (P <0.05), The detection rate of carotid artery plaque of extreme-dipper group was significantly faster than that of non-dipper group (P <0.05).4,The levels of LVMI and IMT was Curve related to the rate of decline in nocturnal blood pressure (P <0.05).Conclusion:This study shows that the extreme-dipper group was particularly prevalent in the elderly with essential hypertension, LVMI,the detection rate of left ventricular hypertrophy,IMT and carotid artery plaque detection rate was higher than the dipper group's,LVMI and IMT was curve related to the rate of decline in nocturnal blood pressure,blood pressure day and night rhythm abnormalities in patients with more severe damage on left ventricular hypertrophy and carotid atherosclerosis..