Relationship Between Blood Pressure Variability And Carotid Atherosclerosis In Elderly Patients With Essential Hypertension

ObjectiveTo investigate the relationship between carotid atherosclerosis(CA) and bloodpressure variability(BPV) in elderly patients with essential hypertension(EH).MethodsA total of154elderly hospitalized patients with essential hypertension (EH), thecarotid ultrasonography operated, according to carotid intima-media thicknesspatients were divided into three groups:①normal carotid artery group（n=47）: IMT（intima-media thickness）<0.9mm;②thickening of the carotid artery group（n=24）:0.9mm≤IMT<1.3mm;③plague of the carotid artery group（n=83）: IMT≥1.3mm.According to the results of24h ambulatory blood pressure monitoring154elderlyhospitalized patients were divided into two groups: dipper group (n=34) andnon-dipper group (n=120). x2test, Student’s t test, and Multiple linear regressionanalysis were used to test the correlations between ABPM mean value, BPV and avariety of risk factors and carotid artery three groups, and between the dipper groupand non-dipper group the difference of carotid atherosclerosis.Results(1) There were no significant differences in age, eGFR and whether to use statindrugs among the groups that the IMTs were different. The ages were significantlyhigher in patients with plague of the carotid artery group than in thickening of thecarotid artery group and normal carotid artery group（69.13±5.93vs.66.46±3.83vs.66.10±5.31, P=0.004, P=0.036）; The ages did not differ between thickening of thecarotid artery group and normal carotid artery group （P=0.846). The eGFRs weresignificantly lower in patients with plague of the carotid artery group than in normalcarotid artery group（110.2±30.56vs.94.27±22.38, P=0.001）; The eGFRs did not differ between thickening of the carotid artery group and plague of the carotid arterygroup（P=0.192). The eGFRs did not differ between thickening of the carotid arterygroup and normal carotid artery group （P=0.199). The usage rates of statin weresignificantly higher in patients with plague of the carotid artery group than inthickening of the carotid artery group and normal carotid artery group （74.5%vs.62.5%vs.92.8%, P=0.000, P=0.004）; The usage rates of statin did not differbetween thickening of the carotid artery group and normal carotid artery group（P=0.296).（2）There were no significant differences in24hSBP, nSBP,24hSTDs, dSTDs,dSTDd,24hSCV, dSCV and dDCV(P<0.05), between the plague of the carotid arterygroup and normal carotid artery group,24hSBP significantly increased（129.1±12.1vs.135.2±13.4, P=0.012）, nSBP significantly increased（124.6±13.4vs.133.2±14.79, P=0.001）,24hSCV significantly increased（0.10±0.020vs.0.12±0.027,P=0.000）. Between the plague of the carotid artery group and normal carotid arterygroup, and Between thickening of the carotid artery group and normal carotid arterygroup,24hSTDs both significantly increased（13.1±2.52vs.14.9±3.06vs.14.9±3.96, P=0.004, P=0.032）, dSTDs both significantly increased（12.1±2.67vs.14.5±3.44vs.14.3±4.00, P=0.001, P=0.009）, dSCV both significantly increased（0.093±0.02vs.0.11±0.02vs.0.11±0.03, P=0.008, P=0.042）, dDCV both significantlyincreased（0.12±0.037vs.0.15±0.048vs.0.14±0.045, P=0.018, P=0.025）.Between thickening of the carotid artery group and normal carotid artery group,dSTDd significantly increased（9.60±2.46vs.11.79±3.71, P=0.012）.(3) Multiple linear regression analysis showed that24hSTDs and24hSCV werepositively correlated with carotid atherosclerosis(P<0.05), and eGFR were negativelycorrelated with carotid atherosclerosis(P<0.05).Conclusion24hSTDs and24hSCV were positively correlated with carotid atherosclerosis inelderly patients with essential hypertension(EH).