Relationship Between Pulse Pressure, Dynamic Pulse Pressure And Left Atrial Dimensions In Patients With Essential Hypertension

Objective:Essential hypertension(EH) is one of the common andfrequently-occurring diseases in clinical threatening health of human being.Asan important and independent risk factors of cardiovascular diseases,it canmake the trouble on the important organs such an heart,kidney and brain.Studies have found that left atrial dimensions enlargement can happen in theearly stage of hypertension,therefore,left atrial expansion is one of the earlyperformance of cardiac involvement in the patients with essentialhypertension.Generally,the level of systolic and diastolic blood pressure isseen as a diagnosis criteria of hypertension as well as a risk of cardiovasculardisease.The systolic blood pressure minus the diastolic pressure is equal to thepulse pressure.The pulse pressure is another risk factor of cardiovasculardisease which is independent of the systolic blood pressure (SBP) anddiastolic blood pressure (DBP).Recently,many researchers take the dynamicpulse pressure as an important predictor in the development of cardiovascularevents,in addition,they have discovered that24hours dynamic pulse pressureis a more exact predictor than clinical pulse pressure.The research aims atiscussing the correlation between pulse pressure,especially the24h ambulatorypulse pressure and left atrial diameter in essential hypertensive patients.Clinicpulse pressure were measured by mercury column hematomanometer.24hmean pulse pressure were tested with ambulatory blood pressuredetermination and hypertensive patients’left atrial diameter were measured byDoppler ultrasound technique.Methods:80(M30,F50) patients with essential hypertension withoutcardiac disease were selected from the vasculocardiology deparment in the2nd affiliated hospital of hebei medical university.They all conform to the 2010revised edition China hypertension prevention and cure guide ofhypertension diagnosis standard,and all for new,antihypertensive therapy ornot regular medication (5half-lives not taking antihypertensive medications)patients.Some diseases are removed such as secondary hypertension,valvularheart disease,cardiomyopathy,severe anemia,thyroid disease,liver and kidneydysfunction and so on.The age,sex,duration of hypertension,height and body weight weremeasured or recorded.The body mass index and body surface area werecalculated according to the height and body weight.The fasting bloodglucose,serum triglycerides,serum total cholesterol,low-density lipoproteincholesterol and high-density lipoprotein cholesterol were measured throughthe hematology inspection.Clinic blood pressure were measured by mercurycolumn hematomanometer.24h ambulatory blood pressure were tested withambulatory blood pressure determination and hypertensive patients’left atrialdiameter were measured by Doppler ultrasound technique.The left atrialdiameter index was calculated through the formula left atrial diameter indexwas left atrial diameter divided by body surface area.All cases were splitedtwo groups which were named A Group and B Group according to LADI(LADI＞2.3cm/m2and LADI≤2.3cm/m2).The correlation between pulsepressure and left atrial diameter index in both groups were analysed.Results:There was no statistically significant difference concerning thebaseline data between the two groups including age,sex ratio,body mass index(BMI),hypertension duration,fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),high-density lipoprotein(HDL),low density lipoprotein(LDL)(P>0.05);The results showed that there were significant differences insystolic blood pressure including clinic systolic blood pressure,24-hourambulatory systolic blood pressure and day systolic blood pressure(P＜0.05);Although the night systolic blood pressure is higher in A Group than BGroup,there were no statistical differences(P>0.05);there were significantdifferences in diastolic blood pressure including clinic diastolic bloodpressure,24-hour ambulatory diastolic blood pressure and day diastolic blood pressure(P＜0.05);Although the night diastolic blood pressure is higherin A Group than B Group,there were no statistical differences(P>0.05); therewere significant differences in pulse pressure including clinic pulsepressure,24-hour ambulatory pulse pressure and day pulse pressure(P＜0.01);Although the night pulse pressure is higher in A Group than BGroup,there were no statistical differences(P>0.05);Multiple stepwiseregression analysis showed that the changes in24h ambulatory pulse pressureand day pulse pressure were closely related to left atrial diameter index(P＜0.05).This study is designed to analyse the influence factors of LADI andinfluence degree.The results show that a regression relationship with LADIinfluencing factors is24h dynamic pulse pressure (PP1)and24h dynamicsystolic blood pressure (SBP1).Standard regression coefficients arerespectively for24h dynamic pulse pressure (PP1):0.325(P=0.002),24hdynamic systolic blood pressure (SBP1):0.217(P=0.01).Conclusion:The results of the present study indicated that the level of24h dynamic pulse pressure and24h dynamic systolic blood pressure aresignificantly related to the left atrial dimensions,24h dynamic pulse pressure isthe largest related to the left atrial dimensions,but the level of clinic pulsepressure has little to do it.It can be more truthful and accurate to guide clinicaltreatment in patients with essential hypertensionthe using the24h ambulatoryblood pressure monitoring.