A Correlation Analysis Of Blood Pressure Variability And Coronary Lesions In Primary Hypertension Patients

Background and objective In our country,the epidemic situation of chronic disease is severe,and cardiovascular diseases accounted for the first reason.Coronary heart disease(CHD)is one of the most common cardiovascular diseases in the clinic,and is a serious threat to human health.In recent years,with the improvement of people’s living standard and the change of the diet,the population of CHD is younger than before.Besides,the morbidity and the mortality of CHD are increasing year by year,all of this making CHD get more and more people’s attention.Hypertension is one of the most important risk factors in cardiovascular diseases.Compared with the normal blood pressure people,hypertension patients are more likely to develop cardiovascular syndrome,and are high risk populations of cardiovascular diseases,especially CHD.With the widespread application of 24-hour ambulatory blood pressure monitoring(ABPM),we found many valuable information about blood pressure parameters from the report,such as blood pressure variability(BPV),the highest blood pressure level,the average blood pressure level,and so on.BPV,it refers to blood pressure fluctuations within a certain time.In the past,a lot of researches suggested that in addition to blood pressure level,the increase of BPV is correlated with the severity of cardiovascular disease,cerebrovascular disease,cognitive dysfunction,kidney disease,and the damage of vessels,which is independent of the average blood pressure level,is a risk factor of cardiovascular event,and increases its incidence and mortality.Besides,compared with other cardiovascular risk factors,the increase of blood pressure variability seems to have a higher predicting prognosis value.However,we should emphasize that the mechanism of BPV is not entirely clear yet,the clinical significance of the BPV can bring what effects is largely unkown.As a result,the purpose of this research is to analyse the correlation between BPV and the severity of coronary lesions in primary hypertension patients,so as to provide reference for clinical prevention and treatment.Method A total of 139 primary hypertension patients who were planned to be diagnosed CHD,in the Cardiovascular Department of First Affiliated Hospital of Zhengzhou University from March 2014 to May 2015 were recruited.All the patients undergone 24 h ABPM and coronary arteriography(CAG)in the same condition.According to the CAG result,patients were divided into two groups: control group(vascular stenosis all less than 50%,n=43),CHD group(at least one vascular stenosis ≥50%,n=96).The CHD group was divided into three groups by Coronary SYNTAX score: mild lesion group(0-22 points,n=49),moderate lesion group(23 to 32 points,n=30),and the severe lesion group(33 points or higher,n=17).Compare the BPV,age,gender ratio,duration of hypertension,smoking ratio,blood lipids,blood glucose,homocysteine,uric acid indicators between the control group and CHD group.Besides,compare all of this indicators and BPV among the three groups of CHD.Moreover,analyse the correlation between the BPV and the Coronary SYNTAX score among the three groups.The data were analysed by SPSS17.0.Result 1.Compared with control group,the CHD group patients had higher male ratio,LDL-C,lipoprotein(a),blood uric acid,smoking ratio,lower HDL-C level,all of this difference had statistical significance(P<0.05).2.Compared with control group,the CHD group patients had higher BPV,especially the increase of all-day systolic blood pressure variability and nighttime diastolic blood pressure variability had statistical significance(P<0.05).3.Compared the general clinical indicators of the three groups in CHD,the difference of female ratio,HDL-C level had statistical significance(P<0.05).4.Compared the BPV of the three groups in CHD,the difference of all-day systolic blood pressure variability and nighttime diastolic blood pressure variability had statistical significance(P<0.05).Correlation analysis results showed that all-day systolic blood pressure variability,nighttime diastolic blood pressure variability had positive correlation with coronary SYNTAX score(r=0.662,P<0.05;r=0.306,P<0.05).5.Multiariable logistic regression analysis showed that all-day systolic blood pressure variability(OR=2.376,95%CI:1.710-3.301,P<0.05)and nighttime diastolic blood pressure variability(OR=1.810,95%CI : 3.448-5.079;P < 0.05)were independent risk factors for CHD.Conclusion 1.The increase of BPV is an independent risk factor for CHD.2.With the increase of all-day systolic blood pressure variability and nighttime diastolic blood pressure variability,the coronary lesions will be more worse.