The Relationship Between The Blood Pressure Variability Of Hypertensive And Left Ventricular Hypertrophy By Acting Average Real Variability As A Blood Pressure Variability Index

Objective:Observe the relation between the blood pressure variability(BPV)of hypertensive and left ventricular hypertrophy(LVH)by acting average real variability(ARV)as a BPV index.Methods:A total of 109 hypertensive patients were recruited from our hospital from January 2015 to October 2017.All selected patients had monitored the ambulatory blood pressure,examinated dechocardiography and sampled fasting blood.Application of American Weilun ambulatory blood pressure monitor 6100 continuously detects 24-hour blood pressure of patients,monitor settings 6am-10pm for the day,every 30min automatically measure blood pressure;10pm-6am set to night,every 1 hour automatically record blood pressure.Patients were collected systolic blood pressure(SBP)and diastolic blood pressure(DBP)for 24 hours(24h),daytime(d),nighttime(n).The left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST)and left ventricular posterior wall thickness(LVPWT)were measured with a sonicator.Also collect the patient's age and gender,the use of antihypertensive drugs,and fasting blood to understand the patient's blood glucose,blood lipids,serum creatinine and so on.ARV was used as the grouping criterion.According to the level of ARV,the patients were divided into low ARV group,medium ARV group and high ARV group.SPSS23.0 was used to analyze the data.The measurement data were expressed as`x±s.The multiple groups were compared by one-way ANOVA,such as equal variance of samples,and the LSD method is used for comparison among groups.If the samples variance is not uniform,Tamhane's method is used.Compare the counting data by using chi-square test.Pearson correlation was used to analyze the correlation between left ventricular mass index(LVMI)and BPV.Multivariate analysis was adopted stepwise linear regression analysis.Results:The general data analysis showed that there was no significant difference between the three groups in terms of gender,age,fasting blood glucose,blood lipids,medication and so on(P>0.05),but the age of medium ARV,high ARV group is higher than low ARV group.The highest systolic blood pressure in each period(24 hours,daytime and nighttime)appeared in the high ARV group,which were 151.6±12.5,158±14.8 and 147.2±12.2mmHg respectively.The discrepancies in 24hSBP?dSBP and nSBP of the three groups all had statistical significance.And the three groups showed a gradual increase in the trend;by further comparison of any pair,the discrepancy between each pair was statistically significant(P<0.05).In high ARV group,24hSBPARV,dSBPARV,nSBPARV and LVMI were higher and had statistical significance compared with the other groups(P<0.05).The maximum LVMI appeared in the high ARV group,which was 128.87±54.33g/m~2.Further statistical analysis showed that the LVMI in patients with high ARV was significantly higher than those in the other two groups(91.54±25.44g/m~2 in low ARV group and 99.43±27.57g/m~2 in medium ARV),and the difference was statistically significant.The highest detection rate of LVH in high ARV group was 64.9%,which was significantly different from the detection rate of LVH in other two groups(10.7%in low ARV group and 11.3%in high ARV group).Correlation analysis between BPV index and LVMI shows that LVMI has correlation with24hSBPARV(r=0.359,P=0.015),dSBPARV(r=0.458,P=0.003)and nSBPARV(r=0.364,P=0.023),including that LVMI had the largest correlation coefficient with and was most correlative to dSBPARV(r=0.458,P=0.003).The correlation analysis between diastolic BPV and LVMI showed that there was no significant difference in diastolic BPV and LVMI between dDBPARV(r=0.115,P=0.491)and nDBPARV(r=0.098,P=0.874)and no evident relevance.Using LVMI as the dependent variable,multivariate linear regression analysis of all the above-mentioned biochemical parameters,blood pressure,age,ARV and other related variables as independent variables showed that daytime systolic blood pressure and total cholesterol were the influencing factors of LVMI(P<0.05).Conclusion:ARV can be used as a reliable BPV index.Increases in 24hSBPARV,dSBPARV and nSBPARV may cause left ventricular hypertrophy(LVH).