Correlations Of Morning Blood Pressure Surge And Artery Elasticity Function In Patients With Essential Hypertension

Background:The conclusion was drawn in latest study the abnormal vascular wall was the main cause of cardiovascular disease and acute cardiovascular cerebral-vascular events incidence. Ambulatory blood pressure monitoring can sensitively and objectively reflect blood pressure level, which is closely related to target organ damage. Now, it is known about the morning blood pressure surge increasing plays a "hammer striking" effect on the target organs in patients with essential hypertension.In hypertension, vascular endothelial damage is the most common lesion to target organs. Arterial elasticity function is one of important ability of artery, the change of which is correlated to the abnormal of vascular wall, and it reflects the artery endothelial function to a large extent. The artery elasticity dysfunction has become an important cardiovascular disease risk indicator. Augmentation index (AI) has been one of the key indicators to evaluate the arterial elasticity, and paid more and more attention to.Objective:To investigate changes of artery elasticity function and morning blood pressure surge in patients with primary hypertension.Methods:A total of 50 inpatients, whose diagnosis were essential hypertension, were recruited for this study between October 2009 and March 2010. Patients consisted of 23 males and 27 females. The age of all patients averaged 49.4±16.7 years (range:16～79), and the time since which they have been hypertensive patients averaged 7.8±9.7 years. Inclusive criteria:Corresponding to diagnostic standards for preventing and treating hypertension instituted in 2005 by Chinese scholars. There were some illness excluded, such as secondary hypertension, diabetes mellitus, acute myocardial infarction, acute brain vascular disease, congestive heart failure which has been uncontrolled, disordered sleeping. According to the result of ambulatory blood pressure monitoring, all patients were assigned into tow groups:Morning blood pressure surge group (MBPS≥23.6mmHg, n=22), non-morning blood pressure surge group (MBPS≤23.6mmHg, n=28). In each group, SBP, DBP, PP, PPI were measured using a non-invasive portable ambulatory blood pressure monitor (ABPM-MobDE490207+90, Spacelabs, USA). At the same time, the radial augmentation index which heart rate correction is 75 times per minute that recorded as AIRP75 were determined using HEM-9000AI type (Japan Omron Corporation) pulse wave detection device to evaluate artery elasticity function.Results:There were no significant differences in age, the time since which patients have been confirmed with primary hypertension. No significant differences were found in FPG, TC, TG, HDL-C, LDL-C, as well BMI, between MBPS group and NMBPS group (P> 0.05). There were no significant differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), pulse pressure index (PPI), between the two groups (P> 0.05). There was significant difference founded in the increase of morning blood pressure surge between MBPS group and NMBPS group (P< 0.01). From the scatterplot of MBPS and AIRP75, it was known that there was a linear relationship between them. And the linear correlation analysis was performed taking MBPS as an independent variable and AIRP75 as a dependent variable. Analysis results showed that AIRP75 was significantly positively correlated to MBPS (r=0.489, P< 0.01). AIRP75 of MBPS group was significantly greater than that of NMBPS group.Conclusion:Morning blood pressure surge is closely related with the development of arteriosclerosis in patients with EH.