Epidemiological Investigation Of Hypertension In Nanchang And The Correlation Between Antihypertensive Drugs And Blood Pressure Variability Caused By Temperature

Objective：To evaluate the effect of calcium channel blocker and angiotensinconverting enzyme inhibitor on blood pressure variability caused by temperatureacccording to the hypertension epidemiological among middle-aged and elderlypeople in Nanchang.Metheds：1.Given the questionnaire and body examination to residents from fivecommunities in Nanchang, who is aged40and above. Anlysis the prevalence,awareness, treatment and control of hypertension.2. The serum samples of participants were tested for concentration levels oflipid, glucose and hemoglobin A1c. Calculated the office mean blood pressure, rangeof blood pressure and coefficient of variance after taken blood pressure three times.Record the real-time temperature when measured blood pressure. According to theresults of the questionnaire and body examination, all participating person dividedinto the normal group and the hypertension group. Then divided the hypertensiongroup into three groups based on whether taking antihypertensive drug and chosenwhich kind of drug: no medicine group; group CCB (taking calcium channel blockeralone), group ACEI (taking angiotensin converting enzyme inhibitor alone).Compared the differences of short-term blood pressure variability (including range ofsystolic blood pressure, range of diastolic blood pressure, coefficient of variance ofsystolic blood pressure and coefficient of variance of diastolic blood pressure)between each two groups. Meanwhile, compared the effect of temperature on officemean blood pressure, range of blood pressure and coefficient of variance of bloodpressure between each two hypertension groups.Results：1.The prevalence, awareness, treatment and control of hypertension in4890cases of middle-aged and elderly people who are aged40and above were24.27%,65.80%,49.45%and5.54%. The control of patients who chose drug therapy was 33.44%. The hypertension prevalence increased with the growth of age. In addition tothe60to69age group, prevalence in male was more than female in other age groups.The rates of mild hypertension and isolated systolic hypertension in the new-foundpatients were26.60%and64.78%. Both of them were up to91.38%. Calciumchannel blocker(61.33%) and angiotensin converting enzyme inhibitor(14.99%) werecommoner than other antihypertensive drugs. The monotherapy proportion one drugwere almost two times than the number that chose combination therapy (58.94%vs31.85%, P<0.05).2. Compared with the normal group, range of systolic bloodpressure(8.87±5.39mmHg vs11.51±6.60mmHg), range of diastolic bloodpressure(5.38±3.82mmHg vs5.96±3.90mmHg), coefficient of variance of systolicblood pressure(0.03±0.02vs0.06±0.03) and coefficient of variance of diastolic bloodpressure(0.03±0.01vs0.05±0.04) were higher significantly in the hypertensiongroup(P<0.05). Range of systolic blood pressure(r=0.35, P=0.02; r=0.26, P=0.01),coefficient of variance of systolic blood pressure(r=0.27, P=0.03; r=0.20, P=0.04),office mean systolic blood pressure (r=0.65,P=0.02; r=0.17, P=0.01) and office meandiastolic blood pressure(r=0.61, P=0.03; r=0.30, P=0.003) in group CCB and nomedicine group correlated to temperature. In addition, short-term systolic bloodpressure variability(0.71mmHg,0.63mmHg), coefficient of variance of systolic bloodpressure(0.059,0.002), office mean systolic blood pressure(0.98mmHg,0.88mmHg)and office mean diastolic blood pressure(0.55mmHg,0.14mmHg) rise significantlywhen temperature declined1℃(P<0.05) in those two groups.However, temperaturehad no significantly correlation on office mean blood pressure and short-term bloodpressure variability in the group ACEI(P＞0.05).Conclusion1. Among the middle-aged and older residents in Nanchang city, the prevalencerate of hypertension and the monotherapy proportion are higher, but the awareness,treatment and control rate of hypertension are lower. Isolated systolic hyeretension iseasy to misdiagnosis.2. Short-term blood pressure variability of the hypertension were graeter thanthe normal group significantly. The correlation between ACEI and temperature was no significant. In addition, the effect of angiotensin converting enzyme inhibitor onshort-term blood pressure variability caused by temperature is superior to that ofcalcium channel blocker.