Study On The Relationship Between Morning Blood Pressure Surge And Coronary Artery Lesions

Objective：To discuss the relationship between morning blood pressure surge and coronary artery lesions.Methods：400patients whoes aged34~84that undergoing coronary angiography were selectedrandomlyinduced,which including male204, female196cases,the average age of these patients was61.21±11.33years old. Ambulatory blood pressure was measured after coronary angiography. All caseswere divided into the morning BP surge group (MBPS group), and non-surge group (NMBPS group). Theseverity of coronary heart disease was expressed by the number of blood vessels involved, total lesionsGensini scores and classification.Results：1. All cases were divided into two group saceording to their blood pressure,MBPS group and non-MBPSgroup.MBPS group included152cases with meanage61.30±10.95years and non-MBPS group included248cases with meanage61.16±11.57years. The rate of coronary lesions was higher in the NMBPSgroup(P＜0.05); the rate of three-vessel lesions,type C lesions and the total lesions Gensini scoresin the MBPS group were higher in the NMBPS group(P＜0.05).2. The rate of coronary lesions was not higher in MBPS group of essential hypertension (EH)patients(P>0.05);the rate of three-vessel lesions and type C lesions in the MBPS group were higherin the NMBPS group,but the rate single-vessel lesions group and type A lesions in the MBPS groupwere lower in the NMBPS group(P＜0.05); the total lesions Gensini scores in the MBPS group werehigher in the NMBPS group(P＜0.05).3. In normal high blood pressure patients, the rate of coronary lesions, three-vessel pathological, type Clesions and the total lesions Gensini scores of MBPS group were higher than the NMBPS group(P＜0.05).the total lesions Gensini scores in the MBPS group were higher in the NMBPS group(P＜0.05)4. In MBPS group of essential hypertension patients was higher total lesions Gensini scores than in normalhigh blood pressure patients with MBPS(P＜0.05). The rate of coronary lesions was higher in MBPSgroup of essential hypertension patients than in normal high blood pressure group.5. Single factor correlation analysis: the results showed that age, history of hypertension, diabetes,24hASBP, dASBP,24hAPP, dAPP, nAPP, MBPS had obvious correlation with the incidence of CHD (P <0.05).6. Multiariable logistic regression analysis result showed that history of hypertension, diabetes,24hASBP,24hAPP,MBPS producer prices in the predictive value of coronary artery narrow degree havingindependentent.The result showed that MBPS was the best predietor for the severity of coronary arterystenosis,without the influenee of diabetes,hypertensive disease,24hASBP、24hAPP.(P<0.05).Conclusion：1. Morning blood pressure surge (MBPS) is closely related to the occurrence of coronary heart disease(CHD), the more morning blood pressure surge (MBPS) is a predict of the severity of coronary heartdisease. 2. Morning blood pressure surge in hypertensive patients increased that associated with the degree ofcoronary artery lesions, and the coronary artery lesions was greater than the normal blood pressure case.3. In our clinical work, attention to moring blood pressure surge impacts on coronary artery lesions in thetreatment of high blood pressure at the same time,lowering the morning blood pressure surge is a sensibleway in hypertension management.