Characteristics And Influencing Factors Of Blood Pressure Variability In Acute High-risk Non Disabled Ischemic Cerebrovascular Events

Objective To analyze the characteristics and influencing factors of blood pressure variability(BPV)in acute high-risk non-disabling ischemic cerebrovascular events(HR-NICE).Information and methods A total of 201 patients were enrolled in the first hospital of Changsha from August 2015 to February 2017.The HR-NICE patients were selected according to the "The guide for diagnosis and treatment of high risk and non deformity ischemic cerebrovascular events",and the healthy subjects matched with the basic condition of HR-NICE patients in the same period were selected as the control group.HR-NICE patients were divided into two groups: high risk TIA(ABCD2≥4)and minor stroke group(group A)of less than 24 h.The group was 68 cases,the average age was 63.09±10.55 years,acute multiple cerebral infarction and intracranial or intracranial large atherosclerotic stenosis more than 50% cases group(group B),of which 60 cases were 65.43±9.93.At the age of.The control group was 73 cases,the average age was 59.59±8.36 years old.The following case data were collected and entered into Excel database:(1)general data: gender,age,NIHSS score at admission,smoking history,drinking history,baseline blood pressure,previous history of disease(diabetes,hypertension,hyperlipidemia,history of stroke,atrial fibrillation,history of vascular stenosis,etc.),Homo hemiassine(Hcy),and low density Lipoprotein(LDL-C),high density lipoprotein(HDL-C),total cholesterol(TC),triglyceride(TG),blood uric acid(UA),bilateral cervical vascular color Doppler and head CT,MRI,and head and neck CTA and other images.When the selected cases were admitted to the hospital,the head CT/MRI was routinely examined,the bleeding was excluded,and the head CT was rechecked 48-72 hours later,and the head CT was reviewed at any time for those who had the symptoms of nerve function defect.(2)monitoring indexes of ambulatory blood pressure: including 24 h SBP,24 h DBP,daytime systolic pressure(d SBP),diastolic diastolic pressure(d DBP),night systolic pressure(n SBP)and night diastolic pressure(n DBP),and the corresponding standard deviation(SD)and variation coefficient(CV)were calculated.Between groups with normal distribution measurement data by the mean and standard deviation(X±S),were compared by t test,do not accord with normal distribution using the median,comparison between groups with rank sum test;The count data were expressed by frequency(%),and the group was compared with the x 2 test.Logistic regression was used in multifactor analysis.1.The age of all the subjects was 27~90 years,the average age was(64.14±10.29)years,group A patients were 68 cases,the average age(63.21±10.55)years,60 cases in group B,average age(65.43 + 9.93)years,the homocysteine and blood uric acid of the group A higher than the group B,but P > 0.05,the difference was not statistically significant.Age,fasting blood glucose,total cholesterol,low density lipoprotein,high-density low-fat protein and triglyceride of the group B were higher than those of the group A,and the difference of triglyceride in the two groups was statistically significant.2.24 h SBP,24 h DBP,d SBP,d DBP,n SBP and n DBP of the group B were all higher than those of the group A,and 24 h SBP,d SBP and d DBP were statistically different(24h SBP).3.The 24 h SBP(SD),24 h DBP(SD),d SBP(SD),d DBP(SD),24 h SBP(CV),24 h DBP(CV),24 h DBP(SD),24 h SBP(CV)of the group B were all higher than those of the group A,of which two groups were statistically significant.In the group A,n SBP(SD),n DBP(SD),n SBP(CV)and n DBP(CV)were higher than those in the group B,and the difference was not statistically significant.4.There was a significant difference in blood pressure among group A,group B and control group(P=0.000).The results of multiple comparison showed that there was no statistically significant difference between the A group and the control group,and the blood pressure values among the Result other two groups were statistically significant.5.The comparison of the standard deviation of dynamic blood pressure among the group A,the group B and the control group,including 24 h DBP(SD),d SBP(SD),d DBP(SD),n DBP(SD),was statistically significant(P<0.05).Multiple comparisons showed that there was a significant difference in n DBP(SD)between the group A and control group(P<0.05).There was a statistically significant difference in 24 h SBP(SD),d SBP(SD),d DBP(SD)and n DBP(SD)between the group B and control group(P<0.05).6.The comparison of the standard deviation of dynamic blood pressure among the group A,the group B and the control group,and the difference of 24 h SBP(CV),d SBP(CV)and n DBP(CV)was statistically significant(P<0.05).Multiple comparisons showed that the difference of 24 h SBP(CV)and d SBP(CV)between the group A and control group was statistically significant(P<0.05).There was a significant difference in 24 h SBP(CV)and d SBP(CV)between the group B and control group(P<0.05).7.Logistic regression analysis showed that the risk factors of the group A were hyperlipidemia,and the risk factors of the group B were coronary heart disease and hyperlipidemia.Conclusion 1.HR-NICE is related to blood pressure variability,especially the systolic blood pressure variability.2.There were significant differences in blood pressure variability among different subtypes of HR-NICE,of which acute multiple cerebral infarction and intracranial or extracranial large atherosclerotic stenosis were greater than 50%.3.Hyperlipidemia is an independent risk factor for normal blood pressure HR-NICE.