The Relationship Between Level Of Primary Hypertension Blood Pressure And Carotid Intima-media Thickness

Objective: To discuss: 1) The role of primary hypertension grading of blood pressure, systolic pressure, diastolic pressure, and mean pulse pressure on carotid artery intima-media thickness; 2) A clear correlation between circadian rhythm of blood pressure and carotid atherosclerosis. Thereby providing new ideas for the prevention and treatment of carotid atherosclerosis.Methods: Collected in line with "Chinese Hypertension Prevention Guide 2010" hypertension standard 240 patients with primary hypertension, according to the blood pressure levels of patients will be divided into grade 1 group, grade 2 group, grade 3 group, and select another normal blood pressure in 80 patients as control group, there total divided into four groups. Then above 4 groups of patients underwent ambulatory blood pressure monitoring, carotid artery color ultrasound and blood biochemical examination.The above cases with 24 hours ambulatory blood pressure monitoring results, according to the mean pulse pressure value, were divided into grade 3 hypertension group(MPP≥70mm Hg), grade 2 hypertension group(MPP=60~69mm Hg) and grade 1 hypertension group(MPP<60mm Hg).The above cases with 24 hours ambulatory blood pressure, according to the nocturnal blood pressure decline rate expressed as(daytime average BP-night average BP)/daytime average BP×100%, were divided into dipper blood pressure group(nocturnal blood pressure decline rate ≥10%) and non dipper blood pressure group(nocturnal blood pressure decline rate <10%).The above cases, according to the measurement results of carotid artery color Doppler ultrasonography as intima-media thickness(IMT) of the carotid artery in value, divided into coronary artery sclerosis group(IMT ≥0.9mm) and non atherosclerosis group(IMT <0.9mm). Discuss the relationship between blood pressure rhythm and IMT.Result: 1. Primary hypertensive groups and the control group of clinical and biochemical index comparison, the difference was not statistically significant(p>0.05).2. Primary hypertension patients with carotid artery IMT values were higher than the control group(p<0.05); the grade 3 hypertension group of the carotid artery in patients with IMT values higher than grade 2 hypertension group and grade 1 group(p<0.05). With the increase of blood pressure values, carotid artery IMT values gradually increased, there was positively correlation(p<0.05).3. Compared with the control group, patients with essential hypertension in systolic blood pressure between the groups of carotid artery IMT value was higher than that of control group(p<0.05); the 3 level group of carotid artery in patients with hypertension IMT value higher than grade 2 hypertension group and 1 level group(p<0.05); with the increase of blood pressure and carotid artery IMT value gradually increased and was positively correlation(p<0.05).4. Compared with the control group, patients with essential hypertension in diastolic blood pressure between the groups of carotid artery IMT value was higher than that of control group(p<0.05); the 3 level group of carotid artery in patients with hypertension IMT value higher than grade 2 hypertension group and 1 level group(p<0.05); with the increase of blood pressure and carotid artery IMT value gradually increased and was positively correlation(p<0.05).5. The mean pulse pressure(MPP) between the groups in sex, age, TC, TG, LDL, FBG, Cr, NUN levels had no significant difference(P>0.05), between ethnic groups have comparable data.6. Primary hypertension pulse pressure group than in the average value of CIMT, there were significant differences(P<0.05); and with the increase of MPP level, the carotid artery IMT values increased, and was positively correlated(p<0.05).7. According to the dynamic blood pressure detection results of grouping, non dipper group and spoon shaped groups of clinical and biochemical index comparison, no significant difference(p>0.05).8. The detection rate of non dipper blood pressure hardening group(65.7%) of the detection rate of non dipper blood pressure was significantly higher than that of Non Hardened group(34.3%), the difference was statistically significant(??= 13.4, P<0.05).9. Circadian rhythm of blood pressure in non spoon shaped and spoon shaped compared to 24 h SBP, 24 h DBP, DSBP, DDBP level in comparison, no significant difference(P>0.05), between ethnic groups have comparable data. In contrast to NSBP, NDBP between the two groups, there was significant difference(P>0.05).Conclusion:1. In patients with essential hypertension and blood pressure levels increased carotid CIMT and plaque formation, and blood pressure levels were positively correlated with.2. The mean pulse pressure in primary hypertensive patients with increased carotid CIMT and plaque formation was positively correlated.3. Circadian rhythm of blood pressure and increased carotid CIMT and plaque formation correlation.4. Predictors of blood pressure, pulse pressure, the average level of blood pressure circadian rhythm can reflect the target organ damage in a certain extent, provides the theory support for the occurrence and development of prevention of cardiovascular and cerebrovascular diseases.