A Correlation Analysis Of Blood Pressure Variability And Hs-CRP,Coronary Lesions In Hypertension Patients

Objectives Discuss the relationship between blood pressure variability and high-sensitivityC-reactive protein, coronary artery disease occurrence and the severity in hypertension Patients.Methods Choose 100 cases of essential hypertension patients who was suspected coronaryheart disease, and do coronary angiography in a standard Judkins way, analy the degree ofcoronary artery stenosis and according Gensini grading method to calculate the coronary lesionsintegral (CAS). All patients were done 24 h dynamic blood pressure monitoring (ABPM).According to the coronary artery angiography results ,the patients were divided into two groups,coronary stenosis groups(at least have a blood vessel diameter quartile narrow≥50%), coronarynormal group(narrow < 50% or normal person). Activities that coronary stenosis in lesions of theleft anterior descending branch, involving left circumflex coronary artery branch and right of thecount (significantly affects the left main program for two), were divided into single lesionsgroup,double teams of pathological changes, three lesions groups. The study measured height,weightand calculate body mass index (BMI). Blood biochemical examination including totalcholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low density lipoproteincholesterol (LDL)-C), etc. high-sensitivity c-reactive protein (hs-CRP) was determined by thelatex immunity enhancement method.Results 1、Age, sex, BMI, TC had no difference between coronary stenosis group and normalgroup (P > 0.05); HDL-c in three lesions disease group was less than normal group, LDL-C inCoronary stenosis group was higher than normal group, single lesion group and double lesionsgroup and the difference was statistically significant (P < 0.05, P < 0.05, P < 0.01)；but thedifferences between single lesions group, double lesions group and three lesions group wasstatistically significant (P > 0.05); 2、The level of hs-CRP was increased by the counts of lesions,differences in normal group and single lesion ,double lesions group, three lesions group werestatistically significant (P < 0.01). 3、The difference of DBP, dDBP, nDBP in Coronary normalgroup, single lesions, double lesions group, three lesions were statistically significant (P > 0.05).Coronary stenosis of the three groups of 24 h systolic blood pressure standard deviation(24hSSD), diastolic pressure standard deviation (24hDSD), and the day of standard deviationsystolic blood pressure (dSSD)and diastolic standard deviation (dDSD), night systolic bloodpressure standard deviation (nSSD), diastolic blood pressure standard deviation (nDSD) arehigher than the coronary normal group, the difference was statistically significant (P < 0.05, P < 0.01, P < 0.01). the difference of SBP, dSBP and nSBP only in double lesions group, threelesions group and coronary normal group were statistical significance (P < 0.05).All of the bloodpressure parameters beteen three lesions group and double teams group was not statisticallysignificant (P > 0.05). coronary lesions scores in three group were statistically significantdifference than single lesions group(P < 0.01, P < 0.001). 4、24 hSSD, dSSD, nSSD, 24 hDSDdDSD and nDSD had a significant positive correlation with hs-CRP respectively (r = 0.461,0.375, 0.271, 0.337, 0.219, 0.18,P < 0.05), and hs-CRP is associated with 24 hSSD mostclosely .5、hs-CRP, 24 hSSD, dSSD, nSSD were positively correlated with CAS (r = 0.618，0.785,0.659,0.484, P < 0.01), and hs-CRP, 24 hSSD had the most influence to CAS, CAS and 24hSSD was most closely related.Conclusions 1、The blood pressure variability in hypertesion patients is closely related to thedegree of coronary lesions, the greater the blood pressure variability, coronary artery diseasedegree is heavier, controling blood pressure variability early has the important meaning tooccurrence and development of coronary heart disease.2、In blood pressure variability in theindex, the relationship between 24 hSSD and CAS is most closely, revealing 24 hSSD as a bloodpressure variability index could be an prognostic assessment indicators for suspicious ofcoronary disease. 3、The process of increase of blood pressure variability is accompanied withsignificant inflammation, and blood pressure variability index (24 hSSD, dSSD, nSSD, 24 hDSD,dDSD,nDSD) and hs-CRP is a significant positive correlation.4、Further verified the process ofcoronary heart disease is accompanied with the inflammation, and the greater inflammation, thedegree of coronary lesions is heavier, the likelihood of multivessel disease is bigger.