The Application Of 24-hour Ambulatory Blood Pressure Monitoring In Hypertensive Patients

Many studies have confirmed that hypertension can lead to heart, brain, kidney and other organs damage. Early detection and timely treatment of hypertension can delay and reduce the target organ damage. ABPM is a non-traumatic, automatic technology. Recently it is used widely in clinical application to measure blood pressure .It can reflect the blood pressure situation more objectively .It has an important value in forecasting hypertension complications risk and valuating prognostic.To explore the relationship between blood pressure and hypertension TOD and determine the correlation between the average level of blood pressure, blood pressure rhythm, blood pressure variability and abnormal blood pressure load and TOD in hypertension. In this paper, it has a retrospective study about the hospital ward of 90 hypertension patients with ABPM from April 2006 to April 2007 in Jilin University Hospital. The results show : The organ damage groups which the mean values of various parameters have a significant or highly significant difference (p<0.05, p <0.01) compared with simple hypertension group.In heart damage group and diabetic group, 24- hours blood pressure average and daytime blood pressure are no significant differences with simple hypertension group.There is a significant or highly significant difference between cerebral group,kidney group and multiple organ damage group compared with simple hypertension group.The kidney group has higher 24 hours SBP . The cerebral group has higher nighttime DBP. IN multiple organ damage group ,the mean values of various parameters has highly significant difference .Non-dippers group complication rate is significantly higher than simple hypertension group. There is more than 50% probability in organ damage group. BPV is the most systolic blood pressure variation that the daytime change more variously than at night variability. It has variations in blood pressure associated with a greater occurrence of TOD. The multiple organ damage group is the most obvious ones. BPL with organ damage group has more highly significant or most significant different than the simple hypertension.Through this group, we note that the majority of patients with essential hypertension, especially in elderly hypertensive patients,blood pressure levels are maintained at a high level. Long-term blood pressure load causes the heart,brain and kidney complications increased. And the heart, brain and kidney significantly higher mean blood pressure at night, considering the night with the slow flow, Arteriosclerosis increased activation of renal sympathetic activity of renin-angiotensin-aldosterone system. The weakening and disappear- rance of circadian rhythm in hypertension patients with the non-dipper blood pressure result blood pressure load and blood viscosity increasing. It will lead to microcirculatory perfusion obstacles, hypoxic-ischemic and cause injury of the kidney,heart and brain. In recent studies,we find that hypertension patients with the circadian rhythm of blood pressure disappearing whose plasma endothelin levels are significantly increased. There is a potential vicious circle between the target organ damaging and endothelin-blood released increasingly and the disappeared pressure rhythm .BPV can reflect target organ damage . That is independent of average blood pressure levels. BPL is more than 50% in multiple organ damage group. White'study find that 40% is a forecast standards in hypertension patient with multiple organ damage. Meanwhile,night time blood pressure load has been evaluated more meaningfully.The results show that ABPM reveals accurately a close correlation with the average level of blood pressure, blood pressure rhythm,blood pressure variability and blood pressure load and TOD in hypertension .It can reflect changes in 24-hour blood pressure rhythm and blood pressure variability and can help doctors control the level blood of pressure and volatility of the hypertensive patients, and relief individualized program.The clinical medical workers should understand each patient's cycle of blood pressure and treatment reasonably in Hypertension treatment. the same time, they should pay attention to the drug of treatment time and drug election to reduce hypertension on the target organ damage.In short, along with the depth of it,s research,ABPM plays an important role in hypertension diagnosis and treatment. It will provide greater assistance for future clinical in work.