| [Background]In2010,《Lancet》、《Hypertension》、《Lancet Neurol》published manypapers related on blood pressure variability[1-5],blood pressure variability become ahot topic once again. Published in2012, Chinese blood pressure measurementguidelines[6],emphasizing the positive significance for cardiovascular andcerebrovascular diseases ofBPV proposed by24h ambulatory blood pressuremeasurements and home blood pressure measurement,BPV has changed people’s viewof the treatment of hypertension, the blood pressure variation control of hypertensionmay be as important as absolute levels of blood pressure. Clinicians should payattention to BPV data in clinical practice, and start to treathigh-risk BPV patients.However, BPV is still need for more clinical research: BPV measurement,optimization BPV indicators, the impact on other prognostic factors BPV, BPVcontrol, etc. Therefore, this study explore these areas, ambulatory blood pressure inthe elderly population and correlation with cardiovascular and cerebrovascular events.[Objective]1. The repeatability of24hours ambulatory blood pressure variability in elderly.2. Characteristics of24-hour ambulatory blood pressure in elderly population.3. hypertension on blood pressure variability.4. Correlation between24-hour ambulatory blood pressure variability withcardiovascular and cerebrovascular events in elderly hypertensive patients.[Object and Method]1. study: retired cadres in Guangzhou mittary command, age≥65years, withsome cognitive function, be able to cope with ambulatory blood pressuremonitoring and related inspection items, no serious liver and kidneydysfunction in a stable condition with no fever, infection other acute diseasescombined.2. Methods: A retrospective analysis of medical records data extracted fromhospital medical records system, according to research needs, design of the " elderly population survey of risk factors for cardiovascular disease," theobject of observation questionnaires, medical records and generalinformation, laboratory test results, time enrollment is January1,2000January1-2003, followed up to December31,2013, mainly as a follow-upapproach based on medical records of follow-up, telephone follow-up ifnecessary.3. Statistical Methods: Blood pressure is measured between the number ofdifferent gender and age groups: data is not normally distributed, usingKruskal Wallis Test and Mann-Whitney U test. General types of differences incircadian rhythms were compared using chi-square test. Different types ofcircadian baseline data were compared by ANOVA. Such as blood pressurevariability differences between different age, BMI, presence of hypertensionand high blood pressure levels. Chi-square test and ANOVA. Whether thedifferences in blood pressure variability using the t test for diabetes.Reproducibility of ambulatory blood pressure measurement data usingmultiple analysis of variance repeated calculations.24-hour ambulatory bloodpressure variability and elderly all-cause mortality, cardiovascular mortality,cerebrovascular death, and relevance of other deaths were analyzed usingmultiple cox regression.[Results]1Baseline dataIn1951patients, there are56ultra-spoon-shaped blood type,311spoon-shaped blood type,856non-spoon-shaped,728anti-spoon-shaped blood type.2Repeatability of24-hour ambulatory blood pressure in elderly population.1951patients,24-hour ambulatory blood pressure measurements ranging from1-31times, the average of24-hour blood pressure measurement frequency is4.03times, the number of blood pressure measurements between differentgender and age groups show no significant difference.Blood pressure variability and blood pressure measurement for each indicatorno significant difference between each measure. 3Characteristics of24hour ambulatory blood pressure in elderly population.dipper blood pressure ratio of>80year old group was significantly lower thanthe other two groups, while the anti-dipper blood pressure was significantlyhigher than the other two groups.>80year old group’s24h systolic SD,nighttime SBP SD,24h diastolic SD, daytime diastolic SD,24h systolic bloodpressure variation coefficient, wSD, ASD, ARV statistically different from theother two groups.Dipper blood pressure proportion in underweight and obese group wassignificantly lower than the other two groups, while the anti-dipper bloodpressure and ultra-dipper blood pressure was significantly higher than theother two groups. Group424h systolic SD, nighttime systolic SD,24hsystolic blood pressure was significantly different coefficient of variation,wSD, ASD, ARV.diabetic group’s dipper blood pressure was significantly lower than the non-diabetic group, while anti-dipper blood pressure was significantly higher thanthe non-diabetic group. There were significant differences in24h diastolic SD,daytime diastolic SD, systolic and diastolic24h coefficient of variation, wSD,ASV, ARV.4Hypertension on blood pressure variability in elderly population.Dipper blood pressure in hypertension is lower than that of no hypertensiongroup, and anti-dipper blood pressure and ultra-dipper blood pressure ratio ishigher than the group without hypertension, in addition to diastolic bloodpressure, other indicators of blood pressure variability in hypertensive groupwere different form no hypertension group.The higher level of hypertension, the lowerproportion of dipper bloodpressure, and higher proportion of ultra anti-dipper dipper blood pressureratio. The average systolic blood grouping three daytime systolic SD,24hnighttime systolic coefficient of variation, there are significant differences inwSD, ASV, ARV. 524-h ambulatory blood pressure variability in elderly hypertensive patients andrelationship with cardiovascular and cerebrovascular events.In1951patients, the ratio of events: the death of the tumor, infection death,cardiovascular death, other death, cerebrovascular death. Proportion ofcardiovascular death and cerebrovascular mortality in hypertensive patientswas significantly higher than the group without hypertension.Age, BMI, carcinoembryonic antigen,24hours mean systolic blood pressurein elderly hypertensive population were risk factors of all-cause mortality.Age, BMI, LDL, S-day-mean, S-24h-SD, S-24h-CV, WSD,ASDS,ARV,blood pressure variability classification are riskfactors for cardiovascular deathin elderly hypertensive population.Age, old cerebral infarction, blood urea nitrogen, creatinine, mean-SBP-daytime, S-24h-mean, S-24h-SD, S-DAY-CV, S-24h-BPVI, WSD, ASV wererisk factors for strokein elderly hypertensive population.Age and carcinoembryonic antigen were the risk factors of other events inelderly hypertensive population.[Conclusion]1. small proportion of super-spoon-shaped in elderly population, the proportionof non-dipper blood pressure is the majority.2. BPV repeatability were well in elderly.3. age, obesity, diabetes related to high blood pressure variability.4. BPV in elderly hypertensive patientswas significantly higher than the groupwithout hypertension, and the higher blood pressure levels, the increasingblood pressure variability.5. BPV is a risk factor of cardiovascular death and stroke events in elderlyhypertensive population independent of blood pressure levels. |
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