Clinical Research Of Ambulatory Blood Pressure Monitoring

Subject:(1)To explore the prevalence of isolated nocturnal hypertension and influential factors of nocturnal blood pressure by ambulatory blood pressure monitoring in high risk of cardiovascular people and to compare various indicators with the other types of hypertension, so as to provide some basic research for the prevention and treatment of rising hypertension.(2) To explore the relation of ambalatory blood pressure and arteriosclerosis i(?)dex and to explore if Ambulatory Arterial Stiffness Index(AASI) is a index of reflecting atherosclerosis and clinical value of AASI, so as to provide some basic research for developing simple and effective detection of arterial elastic function.Methods:There are methods of documentary, investigation, statistics. To measure blood glucose, blood lipid, liver and kidney function, blood, urine, electrolytes, uric acid using an automatic biochemical analyzer and to select ECG, echocardiography. To compare prevalence and influencing factors of Isolated Daytime Hypertension, Isolated Nocturnal Hypertension, Day-Night Hypertension by SAS 9.13 analysis, while analyzing Ambulatory Arterial Stiffness Index, influencing factors and relationship between AASI and 24-hour pulse pressure.Results:(1) In 173 patients,11 patients (6.36%) show normal blood pressure; 3 patients (1.73%) show isolated daytime hypertension,2 patients misdiagnosed with clinic blood pressure, the rate of misdiagnosis is 66.7%; 25 patients (14.45%)show isolated nocturnal hypertension with 23 patients misdiagnosed, the rate of misdiagnosis is 92%; 134 patients(77.46%) show day-night hypertension with 10 patients misdiagnosed, the rate of misdiagnosis is 7.5%.(2) To compare in normal blood pressure group, isolated daytime hypertension group, isolated nocturnal hypertension group and day-night hypertension group, there is not significant difference in heart rate, cholesterol, blood glucose, creatinine, uric acid, dynamic arteriosclerosis index, blood sodium, blood potassium(P>0.05).(3) Blood glucose (P<0.0001), total cholesterol (P=0.136),24 hour pulse rate(P=0.138) impacts night systolic blood pressure the most. Age (P=0.005) and 24 hour pulse rate (P=0.065) impacts night systolic blood pressure the most.(4) Age (P<0.0001), blood glucose (P=0.0123), uric acid (P=0.0619) impacts ambulatory arterial stiffness index(AASI) the most. Age (P<0.001) and blood glucose (P<0.001) impacts 24 hour pulse pressure the most.(5) AASI and 24 hour ambulatory pulse pressure is significantly correlated(r=0.54, p <0.0001).(6) AASI,24 hounpulse pressure and ambulatory systolic blood are positively related. After adjusting age, blood glucose and uric acid,that is same.Conclusions:(1) In 173 patients,25 patients show isolated nocturnal hypertension with 23 patients missed (the rate of misdiagnosis is 92%), which point out the importance of ambulatory blood pressure monitoring for the diagnoses of isolated nocturnal hypertension. To compare Blood biochemical indicators, there is not significant difference in four groups patients, which point out nocturnal hypertension is probably in the early stages of cardiovascular events.(2) The influencing factors of nocturnal diastolic blood pressure are age and 24 hour pulse rate. The influencing factors of nocturnal systolic blood pressure are blood glucose, total cholesterol and 24 hour pulse rate. So influencing factors are different between nocturnal systolic blood pressure and nocturnal diastolic blood pressure. The influencing factors of AASI are age, blood glucose, uric acid.(3)AASI and 24 hour pulse pressure is significantly correlated. AASI,24 hour pulse pressure and ambulatory systolic blood are positively related. So AASI is a indicator reflecting the degree of atherosclerosis.