Characteristics Of Blood Pressure Fluctuation And Function And Analysis Of Cardiac Structure In Patients With Hypertension And Coronary Heart Disease

Objective: To investigate the characteristics of blood pressure wave fluctuation,the structure and the function of the heart in patients with coronary heart disease complicated hypertension.Methods:In this study,74 cases of hypertension and coronary heart disease admitted from July 2015 to December 2016 in the Department of geriatrics and Department of Cardiology affiliated to the First Affiliated Hospital of China Medical University were selected as the observation group.Another 82 patients with simple hypertension who were admitted to our hospital during the same period were selected as control group.The basic conditions of the two groups were matched(such as sex,age,course of disease,smoking history,blood fat,blood sugar,creatinine,urea).Patients were asked to undergo24 hour ambulatory blood pressure monitoring to compare the differences of blood pressure fluctuations between the two groups.The cardiac structure and function of the two groups were compared by color Doppler echocardiography.Results: In the two groups,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,fasting blood glucose,glycated hemoglobin,creatinine and urea were no significant difference(P > 0.05).The mean systolic pressure(SBP),mean diastolic pressure(DBP),the mean diastolic blood pressure(DBP),the mean arterial pressure(MAP),the mean blood pressure from a day to night,the pulse pressure(PP)in patients with hypertension and coronary heart disease were all higher than those of patients with simple hypertension(P < 0.05).The ratio of a day to night spoon type / group of patients with hypertension and coronary heart disease was lower than that of patients with simple hypertension,the difference was statistically significant(P < 0.05).The cardiac structure and function of the patients with hypertension and coronary heart disease were significantly different from those in the simple hypertension group.The left ventricular end diastolic volume,the left ventricular end diastolic wall thickness and the left ventricular end diastolic diameter in the observation group were significantly higher than those of the control group,while the ejection fraction of the observation group was significantly lower than that of the control group,the difference was statistically significant(P < 0.05).Conclusion:The dynamic blood pressure of 24h in patients with hypertension and coronary heart disease has certain specificity:mean systolic pressure,mean diastolic pressure,mean arterial pressure,mean blood pressure day to night and pulse pressure are higher than those of simple hypertension.The ratio of a day to night spoon type / this group of patients with hypertension and coronary heart disease decreased.The cardiac structure and function of patients with hypertension complicated with coronary heart disease were obviously changed: left ventricular end diastolic volume,left ventricular end diastolic wall thickness and left ventricular end diastolic diameter were significantly higher than that of the control group,and the ejection fraction was decreased.It is suggested that the heart disease is not well controlled and the fluctuation of blood pressure is increased in the coronary complicated hypertension group.Therefore,the change of 24 hour ambulatory blood pressure and the change of heart color Doppler echocardiography.can be used to predict the risk of coronary heart disease in patients with hypertension and we can use them to intervene and treat the disease in the early page.