Clinical Study Of Left Ventricular Hypertrophy And Carotid Atherosclerosis In Patients With Morning Hypertension

Objective:By studying the occurrence, features of left ventricular hypertrophy and carotid artery atherosclerosis in patients with morning hypertension,and tho-se with non-morning hypertension to analyze the effect of morning hypertensio-n on the occurrence of left ventricular hypertrophy and artery atherosclerosis.Soas to provide the reference to achieve the hypertension management, and prev-ent the target organ damage and the cardiovascular events.Methods: Sixty subjects with the mild and moderate stage of essential hyperte-nsion were selected in out-patient department, 32 male and 28 female, and theaverage age is 68.17士8.25.The average year of the subjects who are diagnos- ed hypertension is 4士1.4. All selected subjects did not take antihypertensive drug for at least a half months or insist on long-term, regular, effective antihy-pertensive therapy.All these diseases should be excepted: secondary hypertension,congenital heart disease, cardiomyopathy, myocardial infarction,heart failure , rheumatic valvular heart disease,diabetes, stroke, peripheral arterialdisease and serious diseases such as liver and kidney insufficiency, white coat hypertension,severe obesity (more than the standard body weight> 20%) and the patients who sleep on daytime, and work in night time. All patients had 24-hour noni-nvasive ambulance blood pressure (ABP) monitoring. According to the results, Sixty subjects were divided into morning hypertension,and (MS)and non-morninghypertension(NMS).In the meantime, Interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVDd), and left ventricular post-erior wallthickness (LVPWT) were measured by echocardiogram in allpatients. Left ventricular mass index (LVMI) was calculated by Devereux formula.Intima —media thickness(IMT) and plaque were respectively measured by color Dopp-ler scans ultrasonics in the common carotid artery(CCA)and its bifureation(B) .Record the data mentioned above and manage statistic analysis with SPSS 13.0.Results: 1.Compare With the NMS group, IVST, LVM, LVMI of MS group were significantly increased, the difference was statistically significant (P <0.05).2.Compare With the NMS group (43.3%), the detection ratio of left ventricular hypertrophy in MS group was significantly higher (70.0%) (P <0.05).3.Compare With the NMS group, CCA-IMT and BIMT in MS group were significantly higher (P <0.05).4.Compare With the NMS group (40.0%), the detection ratio of plaque in MS group increased (66.7%) (P <0.05),and the crouse score of plaque was significantly higher(P <0.05).5. The spearman rank correlation test showed a positive correlation between CCA-IMT and age in all patients(r=0.269, P<0.05).It is also a positive correlation between BIMT and age (r=0.298, P<0.05).Conclution: There are different degrees of left ventricular hypertrophy, carotid atherosclerosis and plaque formation in most patients with essential hypertensi- on, the morning hypertension has more serious effect on the occurrence of leftventricular hypertrophy and carotid atherosclerosis ,which further affect the tar-get organ damage . Therefore it is important for hypertension management and the target organ damage to lower the morning hypertension.