The Correlative Analysis Between Ankle-brachial Index And Ambulatory Blood Pressure As Well As Sleep Respiratory Conditions In Young And Middle-aged Male Patients With High Blood Pressure

Objectives To explore relationship among ankle-brachial index(ABI), ambulatory blood pressure and sleep respiratory condition in young and middle-aged male patients with high blood pressure through retrospective analysis, to provide epidemiological evidence for early forecast and intervention of arterial stiffness in young and middle-aged male patients with high blood pressure.Methods768young and middle-aged male hospitalization patients with high blood pressure who met the inclusion criteria were enrolled in this study. Blood pressure, height, weight, waist circumference, serum lipid, creatinine, uric acid, fasting glucose were recorded. Ankle-brachial index were examined by the arterial hardness tester(OMRON BP-203RPEⅢ); ambulatory blood pressure were examined by ambulatory blood pressure monitor(American space90217), the24hour average blood pressure, average blood pressure at night, average blood pressure, and morning peak blood pressure were recorded. The sleep respiratory conditions were monitored by Polysomnograph PSG(Kaidi’s SW-SM2000CB). Then another773normotensive patients with corresponding age at Physical Examination Center were set as the control group. The general data and cardiovascular risk factors between the two groups were compared. The young and middle-aged male patients with high blood pressure were divided into normal ABI group and low ABI group, their general data and cardiovascular risk factors were compared. Then ABI was set as a dependent variable, and body mass index, fasting blood-glucose, serum lipid, serum creatinine, smoking history, family history, dynamic blood pressure, sleep and other related factors were set as the independent variable, univariate and multivariate uncondition logistic regression analysis were applied to explore the relationships between ABI, ambulatory blood pressure and sleep respiratory conditions in young and middle-aged male patients with high blood pressure.Results1. The body mass index, fasting blood glucose, total cholesterol, low density lipoprotein, triglycerides, serum creatinine, blood urea nitrogen levels and smoking proportion in hypertensive group was higher than that in normotensive group (P<0.05)2.Age, body mass index in low ABI group is higher than normal ABI group (P<0.05). Fasting blood glucose, total cholesterol, low density lipoprotein, triglycerides, blood urea nitrogen, serum creatinine, blood uric acid levels, smoking and family history proportion in young and middle-aged male patients with high blood pressure were higher than the normotensive group (P<0.05).3.Univariate uncondition logistic regression analysis showed:BMI, low density lipoprotein, morning peak blood pressure, smoking history, family history, breathing disorder index, snoring index, TG, two upper arm SBP differences,24hour average blood pressure, average blood pressure at night, average blood pressure, LSaO2were related with ABI.4.Multivariate uncondition logistic regression analysis showed:The higher the morning blood pressure peak (≥35mmHg), the smaller the ABI (OR=14.328,95%CI16.344-73.854). ABI was smaller when the respiratory disturbance index increased (OR=12.372,95%CI21.322-78.833). Overweight or obesity decreased the ABI values (OR=10.871,95%CI2.650-13.008). The higher the low density lipoprotein (LDL-C), the smaller the ABI (OR=8.719,95%CI15.616-73.854). More the SBP difference between Bilateral upper arm, smaller the value of ABI (OR=8.273,95%CI14.483-35.255). In anti-spatula-shaped and non-dipper-shaped blood pressure patients, the ABI value was smaller when compared to spatula-shaped blood pressure patients (OR=7.324,95%CI,12.234to34.567). Patients with long-term history of smoking had decreased value of ABI (OR=6.3445,95%CI,12.650to46.345). With elevated cholesterol level, ABI values decreased (OR=5.291,95%CI1.682to3.121). With a family history of cardiovascular disease, the ABI value decreased (OR=4.389,95%CI5.823to14.482). Higher the24h mean SBP, smaller the value of ABI (OR=4.283,95%CI8.650to21.234). Higher the mean SBP at night, smaller the value of ABI (OR-3.382,95%CI13.382to34.256). Higher the apnea-hypopnea index, smaller the value of ABI (OR=3.281,95%CI2.632to5.193).Conclusions1. There were more cardiovascular risk factors in young and middle-aged male patients with high blood pressure compared with the normotensive patients and more risk factors in low ABI group than that in normal ABI group.2. Morning peak blood pressure, Respiratory disturbance index, BMI, LDL-C, bilateral upper arm SBP difference, smoking history, TG, cardiovascular family history,24h average SBP, night average SBP, low ventilation average index were significantly related with ABI.