Correlation Between Blood Pressure Varialility And Vascular Endothelial Injury In Eldly Hypertesive Patients With Type2Diabetes

Objective:By analyzing the relationship between blood pressure variability and the level of serum MMP-28, IL-18/IL-10, hs-CRP and LDL-C in elderly hypertensive patients with type2diabetes, to explore the relationship between blood pressure variability and vascular endothelial injury.Methods:One hundred and seventy-four hostipitlized-diagnosed hypertensive patients were divided into two groups, according to whether with diabetes hypertensive group87cases (group A), diabetes group87cases (group B).All cases were performed by24h noninvasive ambulatory blood pressure monitoring, recorded24hour average systolic blood pressure, diastolic blood pressure and blood pressure variability values, tested MMP-28, IL-10, IL-18and hs-CRP level and caculated the IL-18/IL-10value. Results:1.The gender composition ratio, age, BMI, admission systolic blood pressure, diastolic blood pressure, total cholesterol, triacylglycerol and HDL-C were no difference in two groups (P>0.05), LDL-C and FPG levels in group B were significantly higher than those in group A (P<0.05);2.The24hSSD,24hDSD, dSSD, dDSD, nSSD,and nDSD values in group B were significantly higher than those in group A (P<0.05).The dynamic blood pressure variability in the patients of group B were significantly higher than those in group A (P<0.05);3.The serum MMP-28, IL-18, In (IL-18/IL-10) and hs-CRP levels in group B are significantly higher than those in group A, the IL-10levels were significantly lower in group A (P<0.05);4.Partial correlation analysis showed that, after controlling for age, warp knitting rank, sex, BMI, blood lipid and fasting blood glucose,there was positive correlation between MMP-28and24hSSD,dSSD, dDSD,nSSD,24hSBP,24hDBP, the correlation coefficients were0.17,0.335,0.155,0.286,0.353,0.373(P<0.05);There was positive relationship between In (IL-18/IL-10) and dSSD,dDSD,nSSD,24hSBP,24hDBP, the correlation coefficients were0.334,0.169,0.235,0.364,0.365(P<0.05); But there was no statistically significant difference between FPG,hs-CRP,LDL-C and blood pressure variability index (P>0.05);5.Multiple stepwise linear regression analysis showed that:MMP28,LDL-C were risk factor of24hSSD,nSSD in elderly hypertensive patients, the regression coefficients were0.38,-0.161and0.305,-0.16; ln(IL-18/IL-10) can be used as independent risk factor of dSSD, dDSD in elderly hypertensive patients, the regression coefficients were0.38,and0.197,all P<0.05.Conclusion:Type2diabetes may aggravate BPV in the elderly patients with EH, there exists positive correlation between vascular endothelial injury and BPV, vascular endothelial injury can affect BPV of the elderly hypertensive patients, increase BPV.