Relationship Between Long-Term Blood Pressure Variability And Left Ventricular Hypertrophy In Eldly Patients With Masked Hypertension

Objective:To explore the correlation between long-term blood pressure variability based on self-measured blood pressure and left ventricular hypertrophy in elderly patients with masked hypertension,To provide an effective monitoring method to observe the long-term changes of blood pressure in elderly patients with masked hypertension and Provide evidence for preventing and treating the target organ damage caused by it.Method:128 elderly subjects were selected from Community Health Service Center affiliated to our hospital from August 2018 to October 2019,including 72 males and 56 females.All subjects were divided into normotension group(n=78)and masked hypertension group(n=50)according to there blood pressure.The standard deviations of self-measured systolic blood pressure and diastolic blood pressure for the later 6 days in all patients were calculated as as the long-term blood pressure variability of systolic and diastolic blood pressure,respectively.Their left ventricular end systolic dimension(LVDd),interventricular septal thickness(IVST),left ventricular posterior wall(LVPW)were recorded by echocardiographic.Left ventricular mass(LVM)and left ventricular mass index(LVMI)were calculated by Decerux corrector formula.General information and biochemical indicators of all subjects were collected at the same time.Compare the general information,biochemical indicators,clinic systolic blood pressure,clinic diastolic blood pressure,self-measured systolic blood pressure,self-measured diastolic blood pressure,self-measured systolic blood pressure variability(SBPV),self-measured diastolic blood pressure variability(DBPV),LVDd,IVST,LVPW,LVM,LVMI between the two groups to judge the statistical difference.Correlation analysis was performed between self-measured systolic blood pressure variability and self-measured diastolic blood pressure variability with LVDd,IVST,LVPW,LVM,and LVMI,respectively.Multivariate linear stepwise regression analysis was used to study the risk factors of left ventricular hypertension.Results:1.There were no significant differences in age,gender,smoking history,drinking history,body mass index(BMI),triacylglycerol(TG),cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),fasting blood glucose,serum creatinine(Cr),blood urea nitrogen(BUN)between the two groups.(P>0.05).2.The clinic systolic blood pressure,self-measured systolic blood pressure,self-measured diastolic blood pressure,self-measured systolic blood pressure variability,and self-measured diastolic blood pressure variability in the MH group were higher than those in the NH group,and the differences were statistically significant(P<0.05)There was no significant difference in clinic diastolic blood pressure between the two groups.(P>0.05).3.The LVDd,LVPW,LVM,LVMI in the MH group were larger than those in the NH group.The difference was statistically significant(P<0.05),There was no significant difference in IVST between the two groups(P>0.05)4.Spearman correlation analysis was used to studied the correlation between self-measured blood pressure variability and left ventricular parameters in the MH group.The results showed that the self-measured SBPV was positively correlated with LVDd,LVPWT,LVM,and LVMI(r=0.457,r=0.390,r=0.508,r=0.505,P<0.05)The difference is statistically significant,and there is no significant correlation with IVST(r =0.232,P>0.05).The difference is not statistically significant.There were no correlation between self-measured DBPV and LVDd,IVST,LVPWT,LVM,and LVMI(r =-0.054,r = 0.137,r = 0.029,r = 0.052,r = 0.191,P>0.05).The difference is not statistically significant.5.Multiple linear stepwise regression analysis of risk factors of left ventricular hypertension in MH group showed that self-measured systolic blood pressure and self-measured SBPV were independent risk factors of LVDd,LVM,and LVMI.Conclusion: Compared with the elderly subjects with normal blood pressure,the elderly patients with masked hypertension had increased long-term blood pressure variability,which was positively correlated with left ventricular hypertrophy.