Relationship Between Morning Blood Pressure Surge And Carotid Atherosclerosis In Patients With Hypertension

24-hours ambulatory blood pressure monitoring is widely used in clinical practice,and the dynamic blood pressure curve of Chinese people can often be seen as "double peak and one trough".Most of the ambulatory blood pressure monitoring report shows,in early morning near 08:00 blood pressure level is higher than the period of before and after 08:00,and the period after midnight blood pressure often has a trough.Many scholars refer to the intense of blood pressure change as the "morning surge of blood pressure(MBPS)".But at present,the standard definition of MBPS is still ununified.In foreign countries,it is theoretically possible to use systolic blood pressure as a reference,and the slope of the rise of blood pressure is used to define the MBPS.This actual operation is cumbersome,so the clinic often takes the simplified equivalent method to name MBPS.The common method names are:(1)Sleep-trough Surge,(2)Preawakening Surge,(3)Rising Surge,(4)Morning-evening Difference.The first three of these four methods relied on 24-hour ambulatory blood pressure monitoring(ABPM),and the fourth one was based on the family self-test blood pressure.Studies have shown that MBPS have adverse effects on cardiovascular and target organs.However,the unified standard of the first three methods which depend on ABPM still lacks a broad consensus.It is not clear which one is more likely to the reflect relationship between for MBPS and cardiovascular events as well as target organs damage.This article through to examinated ABPM and carotid atherosclerosis in hypertensive patients,discusses the relationship between these three MBPS metering methods and carotid atherosclerosis.Objective: to investigate the relationship between carotid atherosclerosis and morning blood pressure surge in patients with hypertension Methods: 251 patients with hypertension were monitored by 24 h dynamic blood pressure monitoring and color doppler ultrasonography.According to whether or not carotid atherosclerosis,patients were divided into carotid atherosclerosis group(n=182)and non carotid atherosclerosis group(n=69).The blood pressure variability and BP morning surge of two groups were analyzed.Multiple linear regression analysis of IMT was performed.Result: The differences between carotid atherosclerosis group and non-carotid atherosclerosis group were statistically significant in age?TC?LDL-C(p<0.05),and there was no statistically significant difference between BMI,FPG,TG,and HDL-C(p>0.05).Compare with non carotid atherosclerosis group,the difference between 24 h SBPSD,n SBP SD,Sleep-trough Surge was statistically significant(14.5±3.0 vs 13.6±2.8,P<0.05;12.9±3.9 vs 11.7±3.6,P<0.05;19.9±15.3 vs 13.9±11.4mm Hg,P<0.05).Multiple regression analysis showed that cholesterol,Sleep-trough Surge were the risk factors of IMT.Conclusion:Patients with carotid atherosclerosis have higher BPV ? MBPS and Tc.The Sleep-trough Surge can better reflect the relationship between MBPS and carotid atherosclerosis.