Study On The Relationship Between Ambulatory Blood Pressure Changes And Heart Rate Variability In Patients With Essential Hypertension And Type 2 Diabetes Mellitus

ObjectiveTo investigate the correlation between blood pressure dynamic changes and heart rate variability in patients with essential hypertension and type 2 diabetes mellitus and the related factors affecting the circadian rhythm of blood pressure.MethodA totle of 186 patients hospitalized in the second hospital affiliated to Zhengzhou University from August 2018 to August 2019 and performed 24-hour ambulatory blood pressure monitoring(ABPM)were analyzed through case reviews.Patients were divided into dipping group which contained 78 patients(SBPF 10%-20%)and non-dipping group which contained 108 patients(SBPF<10%).age,gender,smoking ratio,duration of hypertension,duration of diabetes mellitus,blood biochemical indicators,dynamic blood pressure indicators,heart rate variability indexes,CAD radio were compared among the two groups.To investigate the correlation between blood biochemical indicators and heart rate variability in patients with essential hypertension and type 2 diabetes mellitus by the person correlation analysis and the related factors affecting the circadian rhythm of blood pressure by the multiple linear regression analysis.Result1.Compared with dipping group,CAD radio,duration of diabetes mellitus,glycated hemoglobin in non-dipping group were significantly increased(P<0.01 or P<0.05),age,gender,smoking rate,duration of hypertension,total cholesterol,glycerin trilaurate,low density lipoprotein cholesterin,high density lipoprotein cholesterol had no significant difference(P>0.05).2.Comparison of dynamic blood pressure indexes:Compared with dipping group,24h SBP,n SBP,n DBP in non-dipping group were significantly increased(P<0.01),while SBPF were significantly lower(P<0.01).However,there were no significant differences in the 24h DBP,d SBP,d DBP between the two groups(P>0.05).3.Comparison of dynamic ecg monitoring indexes:Compared with dipping group,24hMHR in non-dipping group was significantly increased(P<0.01),while SDNN?SDANN?RMSSD?PNN50 were significantly lower(P<0.01).4.All objects were analyzed by the person correlation analysis.SBPF was negatively correlated to 24hMHR,while positively correlated to SDNN?SDANN?RMSSD?PNN50.5.The multiple linear regression analysis showed that SDNN?PNN50?24hMHR?24hSBP?nSBP?duration of diabetes mellitus?glycated hemoglobin?CAD radio were influential factors of SBPF.Conclution1.Decreased nocturnal reducing rate of pressure was related to decreased heart rate variability in patients with essential hypertension and type 2 diabetes mellitus.2.SDNN?PNN50?24hMHR?24hSBP?nSBP?the course of diabetes,glycosylated hemoglobin,coronary disease were the influencing factors of the decrease rate of night systolic blood pressure.