The Relation Between Blood Pressure Circadian Rhythm And Hypersensitive C‐reactive Protein And Neutrophil To Lymphocyte Ratio In Patients With Essential Hypertension

Objective Hypertension is one of the most common cardiovascular diseases in China,which can damage the target organ easily.At present,there are about 270 million patients with hypertension in China.Epidemiological survey has shown that abnormality of circadian rhythm can cause increase of the target organ damage and cardiovascular events.Changes of circadian rhythm of blood pressure are regulated by the nervous and humoral systems.In the regulation of humoral system,the endothelial vascular system plays an important role.Inflammation is a high risk factor for hypertension.Theoretically it can damage the endothelial cells and develop atherosclerosis to participate in changes of circadian rhythm of blood pressure.However the relevance between circadian rhythm and inflammation has little specific research.The study is to explore the relationship between the changes of circadian rhythm and hypersensitive C-reactive protein(hs-CRP),neutrophils to lymphocyte ratio(NLR)in patients with hypertension.Methods A total of 365 patients with primary hypertension undergoing 24 h ambulatory blood pressure monitoring were divided into two groups: dipper group [the nocturnal blood pressure decline rate of ≥10%(n=166)] and non-dipper group [the nocturnal blood pressure decline rate of <10%(n=199)],Hypersensitive C-reactive protein and Neutrophil to lymphocyte ratio were detected in all patients.Result 1.Compared to patients in dipper group,the age was significantly higher in non-dipper group[60.13±14.62vs55.64±14.30 years old(P<0.01)].2.Compared to patients in dipper group,mean nocturnal systolic pressure and mean nocturnal diastolic pressure were increased in non-dipper group[140.05±16.33vs123.92±20.10mmHg;82.11±14.18vs76.89±13.00mmHg(P<0.01)],but the mean daytime diastolic pressure was declined in non-dipper group[85.28±16.00 vs 89.00±14.94mmHg(P<0.01)].3.Compared to patients in dipper group,the level of hs-CRP was significantly higher in non-dipper group[4.24±6.59vs2.20±3.49mg/L(P<0.01)].4.The relationship between smoking and the nocturnal systolic blood pressure decline rate was positively correlated(r=0.127,P<0.05),relationships of FBG、sex、age、hs-CRP、NLR with the nocturnal systolic blood pressure decline rate were negatively correlated(r=-0.129、-0.165、-0.231、-0.276、-0.103,P<0.05).5.Stepwise multivariate linear regression suggested that age and hypersensitive c-reactive protein may be the influencing factor of blood pressure circadian rhythm[partial regression coefficient(B):-4.868、-1.863(P<0.01)].Conclusion 1.Compared to patients in dipper group,the level of hs-CRP was significantly higher in non-dipper group.2.Hypersensitive C-reactive protein may be the influencing factor of blood pressure circadian rhythm in patients with essential hypertension.3.Inflammation-related factors elevated may be one of the mechanisms leading to the target organ damage and end point events increased in patients with hypertension,which circadian rhythm were disappeared.Clinical antihypertensive therapy should try to restore the circadian rhythm of blood pressure,while the intervention of its inflammatory factors may bring further clinical benefits.