Circadian Rhythm Characteristics Of Blood Pressure In Hypertension Patients And Its Relationship With Target Organ Damage

Objective:By analyze the circadian rhythm characteristics of blood pressure in hypertensions, discuss the relations between hypertension and the circadian rhythm characteristics of blood pressure. By analyze the circadian rhythm characteristics of blood pressure in hypertensions with tatget organ damage, discuss the relations between the occur and development of target organ damage and blood pressure circadian rhythm characteristics. Provide some valuable reference for hypertension in prognosis s diagnosis and chronotherapy. Methods:This research has collected 24h ambulatory blood pressure data and general clinical information data (including height, weight, past medical history, smoking history, biochemical tests, echocardiography examination, carotid ultrasonography examination,24h urine protein examination, ECG) of 109 cases who were early hypertions degreed 1 or 2 in Department of Cardiology and Department of Physical examination, the second People Hospital of Yibin, First of all, using Single cosinor created by Halberg, the founder of Chronobiology, to study the data of each 24h ambulatory blood pressure, heart rate. Then according to the hypertension'diagnostic criteria in hypertension guidance in China in 2005 and the hypertension'diagnostic criteria of 24h ambulatory blood pressure (ABPM) in hypertension guidance in China in 1999, all subjects were divided into hypertensive (HP) 72 cases and normal control (NM) 37 cases. Using the Population mean cosinor created by Halberg, the founder of Chronobiology, to study the data of 24h ambulatory blood pressure, heart rate of hypertension group and normal control group. Finally, according to the diagnostic criteria of target organ damage, hypertension group was divided into the hypertension with target organ damage group (HPTD) 42 cases and hypertension not with target organ damage group (HPN) 30 cases. Using the Population mean cosinor created by Halberg, the founder of Chronobiology, to study the data of 24h ambulatory blood pressure, heart rate of hypertension with target organ damage group and hypertension not with target organ damage and normal control group. Results:1. Minnesota single cosine analysis:all subjects 24-hour systolic blood pressure, diastolic blood pressure, heart rate showed a significant circadian rhythm (P<0.05).2. the results of hypertensive groups and normal control group'population mean cosinor analysis:sistolic blood pressure population mean cosinor analysis showed that the hypertension group and normal control group'systolic blood pressure whole circadian rhythm is existed (P<0.05), hypertension was significantly higher than the control group in mesor (P<0.01), the amplitude was significantly lower than the control group (P<0.05); diastolic blood pressure population mean cosinor analysis showed that the hypertension group and normal control group' systolic blood pressure whole circadian rhythm is existed (P<0.01), hypertension group was significantly higher than the normal control group in mesor (P<0.01), the amplitude is no significant difference than the normal control group (P>0.05); heart rate population mean cosinor analysis showed that the hypertension group and normal control group'systolic blood pressure whole circadian rhythm is existed (P<0.01), hypertension group was significantly higher than the normal control group in mesor (P<0.05), the amplitude was significantly lower than the control group (P<0.05).3. the results of hypertensive with target organ damage groups and hypertension not with target organ damage groups and normal control group'population mean cosinor analysis:sistolic blood pressure population mean cosinor analysis showed that the hypertension with target organ group'systolic blood pressure whole circadian rhythm is not existed (p>0.05), hypertension not with target organ damage group and normal control group'systolic blood pressure whole circadian rhythm is existed (P<0.05); hypertension with target organ damage group and hypertension not with target organ damage group was significantly higher the normal control group in mesor (P<0.01), hypertension with target organ damage group was significantly lower than the normal control group in amplitude (P<0.05), hypertension not with target organ damage group and the normal control group was no significant difference in amplitude (P>0.05), hypertension with target organ damage group and hypertension not with target organ damage group was no sigmificant difference in the mesor and the amplitude was no significant difference (P>0.05); diastolic blood pressure population mean cosinor analysis showed that three groups'diastolic blood pressure whole circadian rhythm is existed (p<0.05), hypertension with target organ damage group and hypertension not with target organ damage group was significantly higher than the normal control group in mesor(P<0.01), hypertension with target organ damage group were significantly lower than the normal control group in amplitude (P<0.05); hypertension not with target organ damage group and the normal control group was no significant difference (P>0.05), hypertension with target organ damage group and hypertension not with target organ damage group was no significant difference in the mesor and the amplitude (P>0.05); heart rate population mean cosinor analysis showed that three group'heart rate whole circadian rhythm is existed (p<0.05), hypertension with target organ damage group, hypertension not with target organ damage group was significantly higher than the control group in mesor(P<0.05), hypertension with target organ damage group is significantly lower than normal comtrol group in amplitude (P<0.05), hypertension not with target organ damage group and the normal control group was no significant difference in amplitude (P>0.05), hypertension with target organ damage group and hypertension not with target organ damage group was no significant difference in mesor and amplitede(P>0.05). Conclusions: 1.hypertensions and normal blood pressures,24h systolic blood pressure, diastolic blood pressure, heart rate showed a significant circadian rhythm; 2. compared with normal blood pressures, the characteristics of blood pressure and heart rate circadian rhythm in hypertensions is the systolic blood pressure, diastolic blood pressure, heart rate increased in mesor and systolic blood pressure, heart rate decreased in amplitude; 3. target organ damage in the hypertensions is associated with the circadian rhythm characteristics of blood pressure, heart rate. compared with normal blood pressures, hypertensions with target organ damage systolic blood pressure whole circadian rhythm is not exsisted, systolic blood pressure, diastolic blood pressure, heart rate increased in mesor and decreased in amplitudes; 4. to find out the characteristics of blood pressure and heart rate circadian rhythm is useful for diagnosis of prognosis and chronotherapy to the hypertensions.