| Objective: To investigate the relationship between Morning Blood Pressure Surge(MBPS)and Senile degenerative heart valvular disease and provide guidance for clinical prevention and treatment.Retrospective analysis and Study on the parameters of echocardiography,24 hour ambulatory blood pressure monitoring and clinical data.Methods: 1.Two hundred and sixteen patients who met the inclusion criteria and were examined by echocardiography were randomly induced.2.All patients(mean age75.75±8.26 years old,122 males and 94 females)underwent 24 hour ambulatory blood pressure monitoring.All cases were divided into morning blood pressure surge group and morning blood pressure normal grope.3.Acquired the clinical data,incuding SBP,DBP,gender,age,height,weight,personal history,family history(smoking,diabetes,coronary heart disease and hyperlipidemia).Furthermore,blood lipid(TG,TC,HDL-c,LDL-c),and C-reactive protein were determined.Recording the results of echocardiography examination for an observation of the cardiac structure,function and so on.4.Comparing the basic clinical datas in these two research groups,to analyze the risk factor for the occurrence and development of MBPS in the elderly population and relations between MBPS and valwlar calcifcanon in patients.Results:1.General data analysis: There were no significant differences on incidence rate of MBPS between male(54.54%)and female(45.46%)in these two groups(P=0.68>0.05).But there were significant difference between MBPS group and non-MBPS group on the history of diabetes and coronary heart disease(P<0.05).The two groups in the history of smoking and smoking rates have no statistical significance(P=0.58>0.05).2.(1).The proportion of patients with heart valve calcification in the MBPS group was significantly higher than that in the non-MBPS group;The aortic valve and aortic valve were significantly higher than the non-MBPS group in the MBPS group(25.26% vs 12.82%,P<0.001;17.18% vs 7.69%,P<0.001).(2).The average SBP and the Morning peak level in the MBPS group were higher than that in the non-MBPS group,the difference was statistically significant(P=0.003).(3).The level of CRP were significantly higher than the non-MBPS group in the MBPS group(P=0.037<0.05).3.With the increase of the age,the degree of the morning peak has a gradual increasing trend,and the difference between the groups has statistical significance(P<0.001 or P<0.015).Sex and blood pressure in men and women were not related to the MBPS(P=0.68),but the difference between men and women in the degree of the morning peak was statistically significant(P=0.002).4.The age,gender,Course of hypertension,level of LDL-C、CRP and aveage SBP,smoking history,history of diabetes mellitus and coronary heart disease were positively correlated with heart valve degenerative disease(P<0.05),on the contrary the TC,TG,BMI and DBP correlation was not statistically significant(P>0.05).5.Multivariate stepwise logistic regression analysis showed that,after the exclusion of the heart valve degenerative calcified lesions associated with age,average systolic blood pressure and duration of hypertension and other factors,MBPS independent factor affecting the development of heart degenerative valve calcification.Conclusions:1.The MBPS and the degree of the morning peak were closely related to the heart valve calcification,which were the independent influencing factors of the development of the heart valve calcification.2.Age is the non controlling factor of blood pressure morning peak,which is closely related to the degree of the morning peak;3.The gender is not the risk factor of the MBPS,but there is a difference between men and women;... |
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