Correlation Analysis Of Blood Pressure Variability,Inflammatory Markers And Degree Of Carotid Atherosclerosis In Patients With Essential Hypertension

ObjectiveTo explore the relationship between blood pressure variability,inflammatory markers and the degree of carotid atherosclerosis in patients with essential hypertension Methods136 patients with essential hypertension who were admitted to the Second Affiliated Hospital of Zhengzhou University from September 2018 to September2020 were selected.The patients were monitored for 24 hours ambulatory blood pressure and divided into dipper group(44 cases)and non-dipper group(56 cases)and the anti-dipper group(36 cases)according to the circadian rhythm of systolic blood pressure.gender,age,BMI,smoking history,blood biochemical indicators,inflammatory markers and carotid atherosclerosis were compared among the three groups.Correlation analysis was used to explore the relationship between the 24-hour blood pressure variability,inflammatory markers and carotid atherosclerosis in patients with essential hypertension.Results1.Compared with gender,age,smoking history,body mass index(BMI),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)of the three groups patients,the difference was no significant difference(P>0.05).2.Compared of inflammation markers: hs-CRP,IL-6 and TNF-α were significant differences among the three groups of patients(P<0.05),The hs-CRP of the anti-dipper group was higher than the non-dipper group(P<0.01),The hs-CRP of the anti-dipper group was higher than that of the dipper group(P<0.01),The hs-CRP of the non-dipper group was higher than that of the dipper group(P=0.016);IL-6 in the anti-dipper group was higher than that in the dipper group(P<0.01),IL-6 in the non-dipper group was higher than that in the dipper group(P<0.01),There was no significant difference in IL-6 between the anti-dipper group and the non-dipper group(P=0.165);TNF-α in the non-dipper group was higher than that in the dipper group(P=0.003),TNF-α in the anti-dipper group was no significant difference with the non-dipper group(P=0.980),TNF-α in the anti-dipper group was no significant difference with the dipper group(P=0.092);3.Compared of carotid atherosclerosis: The detection rate of carotid atherosclerotic plaque formation in the anti-dipper group was higher than dipper group(P=0.007);The detection rate of carotid atherosclerotic plaque formation in the anti-dipper group was higher than non-dipper group(P=0.016);The normal detection rate of carotid artery intima in the dipper group and non-dipper group was higher than dipper group(P=0.001,P=0.043);The detection rate of carotid atherosclerotic plaque formation in the anti-dipper group was higher than non-dipper group(P=0.016);4.Pearson correlation analysis: Combine d SBP,n SBP,n SSD,n SCV,n DSD,n DCV,24 h SSD,24 h SCV,24 h DSD and 24 h DCV with smoking history,age,BMI,blood lipids,hs-CRP,IL-6,TNF-α Perform pairwise correlation analysis separately,There is a significant positive correlation between hs-CRP and n SBP(r=0.475,P<0.05),and a negative weak correlation with n SCV(r=-0.243,P<0.05);There is a significant correlation between IL-6 and n SBP,n DCV,24 h SCV and 24 h DCV(r value is between 0.2 and 0.4,P<0.05),The correlation between TNF-α and n SBP was not significant(r=0.187,P<0.05),There is a weak correlation between the degree of carotid atherosclerosis and n SBP(r=0.233,P<0.05),There is a weak correlation between age and n SBP(r=0.225,P<0.05),There is a weak correlation between TC and 24 h SSD(r=0.215,P<0.05);The correlation test among the remaining parameters is r <0.2 or no statistically significant(P>0.05).Conclusions1.Compared with essential hypertension patients with normal blood pressure circadian rhythm,those with abnormal blood pressure circadian rhythm have higher inflammatory markers and more severe carotid atherosclerosis;2.The circadian rhythm of blood pressure is related to the degree of carotid atherosclerosis.As the circadian rhythm decreases,the degree of carotid atherosclerosis increases;3.In patients with essential hypertension,hs-CRP is negatively correlated with24-hour blood pressure variability,IL-6 is positively correlated with 24-hour blood pressure variability,and the degree of carotid atherosclerosis is positively correlated with nighttime mean systolic blood pressure.