Study On The Effect Of Abnormal Blood Pressure Circadian Rhythm And MMP-9 On Cognitive Function In Patients With Hypertension And Leukoaraiosis

BackgroundWith the aging of the population and the change in lifestyle,the incidence of hypertension and leukemia has increased year by year,Cognitive impairment is one of the main problems for the elderly.Relevant studies have shown that white matter osteoporosis is one of the early signals of cognitive impairment.In patients with hypertension combined with white matter osteoporosis,the abnormal circadian rhythm of blood pressure has a great influence on the cognitive impairment of patients,and MMP-9 is positively correlated with the severity of white matter osteoporosis.The purpose of this study was to explore the effect of abnormal circadian rhythm of blood pressure on cognitive impairment in patients with hypertension complicated with white matter osteoporosis,and the relationship between MMP-9 and cognitive function,so as to provide a basis for clinical intervention.ObjectiveThe cross-sectional study was used to analyze the patients with hypertension and leukoaraiosis.The patients with circadian rhythm abnormality were divided into different types of hypertension.The biochemical indexes and cognitive function of different groups were compared,and the influencing factors of cognitive dysfunction in patients with hypertension and leukoaraiosis were further analyzed.MethodsFom February 2019 to February 2020,200 patients with hypertension and leukoaraiosis admitted in our hospital were selected.According to whether patients detected abnormal blood pressure circadian rhythm,they were divided into abnormal rhythm group and normal rhythm group(control group).There were 84 cases in the abnormal rhythm group and 116 cases in the control group.Collect the age,sex,years of education,marital status,past disease history,and blood pressure of the research subjects.24-hour day and night pressure,24-hour systolic pressure,24-hour mean,day and night pressure,Night-time and night-time mean pressure were measured by non-invasive ambulatory blood pressure measurement.After patients experienced a decrease in blood pressure,no diving blood pressure,high blood pressure and a frequent reversal of blood pressure.Fazekas score was used to grade the MRI results.The cognitive function was evaluated with the montreuter cognitive scale(Mo CA),including visual space and executive ability,orientation,attention,naming,abstract generalization,language ability and delayed recall.On the morning of the second day after admission,fasting venous blood was collected to detect the biochemical indexes,including aspartate aminotransferase(AST),urea nitrogen(BUN),alanine aminotransferase(ALT),uric acid(UA),creatinine(CR),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and total cholesterol(TC).ELISA was used to detect the level of MMP-9 in peripheral blood.Pearson correlation analysis was performed between MMP-9 and MOCA score.Results(1)There was no significant difference in age,gender,high blood pressure and history of previous diseases between the two groups(P > 0.05).The education years of the abnormal rhythm group were higher than those of the control group(P < 0.001).(2)There was no significant difference in AST,ALT,BUN,Cr,TC,UA,LDL-C,HDLC between the abnormal rhythm group and the control group(P > 0.05).The level of MMP-9 in arrhythmia group was higher than that in control group(P < 0.001)..(3)There were significant differences in MOCA total score,visual space and executive ability score,naming score and delayed recall score among dipper group,non dipper group,super dipper group and reverse dipper group(P < 0.05).(4)There was no significant difference in orientation ability score,attention score,abstract generalization score and language ability score among dipper group,non dipper group,super dipper group and reverse dipper group(P > 0.05).(5)Multivariate logistical regression analysis showed that an abnormal circadian rhythm of blood pressure is directly related to a cognitive impairment in patients with hypertension and leukaemia(OR = 1.442,P = 0.004),and reverse dipper blood pressure type had the greatest impact on patients with hypertension and leukoaraiosis(P < 0.05).Conclusions(1)The level of MMP-9 in the circadian rhythm abnormal blood pressure group was higher than that in the control group,and the MMP-9 in the circadian rhythm abnormal blood pressure group was negatively correlated with the MOCA score.(2)Abnormal circadian rhythm of blood pressure is directly associated with cognitive dysfunction in patients with hypertension and leukaemia.The cognitive functions in patients with different circadian rhythms under blood pressure were different and cognitive disorders in patients with inverse dipper types were most evident..