Clinical Study Of The Relationship Between Blood Pressure Variability, Blood Pressure Circadian Rhythms And Carotid Artery Atherosclerosis In Patients With Essential Hypertension

Objective To investigate the relationship between blood pressure variability, bloodpressure circadian rhythms and carotid artery atherosclerosis in patients with essentialhypertension.Methods Select patients with essential hypertension in84cases,of which47cases ofmale, female37cases, aged40to86years old, the average age (71.68±10.31) yearsold;Application of color doppler ultrasound to monitor the carotid arteryintima-media thickness(IMT),according to the results of the color dopplerultrasound all selected patients were divided into two groups: the group withsclerosis(38cases) and the group without sclerosis(46cases).Meanwhile all the patientswere underwent examination of the24h ambulatory blood pressure monitoring,thenwrote down the mean blood pressures (systolic blood pressures,diastolic bloodpressures and pulse pressures) and the blood pressure standard deviations(systolicblood pressure standard deviations and diastolic blood pressure standard deviations) of24h,daytime and night time.According to the results of the24h ambulatory bloodpressure monitoring we classified all the patients as dipper group(47cases) andnon-dipper group(37cases). The record of medical history, physical examination andbiochemical parameters (such as glucose, blood lipids and so on) were performed in allthe patients. Then the data comparisons were made. Results1. There were no significant differences between the group with sclerosis and thegroup without sclerosis in clinical manifestations and biochemical parameters.(P>0.05).2.The mean systolic blood pressures and pulse pressures of24h, daytime and nighttime in the group with sclerosis were much higher than those in the group withoutsclerosis (P<0.05orP<0.01). Although there were different in the mean diastolicblood pressures of the two groups, all showed no statistically significance (P＞0.05).3. The blood pressure variability of24h,daytime and night time and the intima-mediathickness(IMT) in the the group with sclerosis were all higher than those in the groupwithout sclerosis(P<0.01).4. The correlation analysis of IMT and BPV showed that there was a positivecorrelation between IMT and24hSSD,24hDSD, dSSD, dDSD, nSSD, nDSD.5. The detection rate of non-dippers in the sclerosis group (57.9%) was higher than thatin the group without sclerosis (32.6%,χ~2=5.40, p<0.05).6. According to the results of the24h ambulatory blood pressure monitoring, therewere no significant differences between non-dipper group and dipper group inclinical manifestations and biochemical parameters.(P>0.05).7. The night time blood pressures (nSBP, nDBP, nPP) of non-dipper group weresignificantly higher than those in dipper group (P<0.05). Although there weredifferent in24h blood pressures (24hSBP,24hDBP,24hPP)and daytime bloodpressures(dSBP,dDBP,dPP) of the two groups, all showed no statisticallysignificance (P＞0.05).8. The IMT and detection rate of carotid artery atherosclerosis in the non-dippergroup were both higher than those in dipper group (P<0.01). Conclusions1. The blood pressure variability, blood pressure circadian rhythms are all closelyassociated with carotid artery atherosclerosis in patients with essential hypertension.2. In some way blood pressure variability and blood pressure circadian rhythms canbe used as important indexs which can reflect target organ damage and predict thecardiovascular events.