Relationship Between Blood Pressure Variability And White Matter Lesions In Elderly Hypertension Patients

Objective:1.to investigate the relationship between White Matter ischemic Lesions and 24 h Blood Pressure Variability in elderly patients(?60 years old).2.to investigate the relationship between White Matter ischemic Lesions and risk factor of cerebrovascular diseasein elderly patients(?60 years old).Methods:A total of 71 patients with essential hypertension in Department of Neurology of the First Affiliated Hospital of Guangxi Medical University,from June 2015 to December 2016,were selected,after admission to examine cerebral MRI and24 h ambulatory blood pressure(ABPM).On the basis of cerebral MRI,Fazekas grading method of leukoaraiosis was used to devide patients into two classification: low level group(not and mild leukoaraiosis)and high level group(moderate and severe leukoaraiosis).The clinical data such as gender,age,history of smoking,history of drinking,history of diabetes,history of coronary heart disease and the clinical indicators such as low density lipoprotein cholesterol(LDL-C),triglyceride(TG)and serum cholesterol(TC)were investigated.Analysis of 24 hour ambulatory blood pressure parameters,including:(1)the heart rate of each period: 24 h heart rate(24hHR),daytime heart rate(d HR),and night-time rate(nHR);(2)the mean blood pressures of each period:the average systolic blood pressure of 24h(24hSBP)and diastolic blood pressure of 24h(24hDBP),the average systolic blood pressure(dSBP)of the daytime and diastolic blood pressure of daytime(dDBP),the average systolic blood pressure(nSBP)of night-time and diastolic blood pressure of night-time(n DBP);(3)the coefficient variation(CV)of each period: 24 h coefficient variation of systolic blood pressure(24hSBPCV)and diastolic blood pressure(24hDBPCV),daytime coefficient variation of systolic blood pressure(dSBPCV)and diastolic blood pressure(dDBPCV),and night-time coefficient variation of systolic blood pressure(nSBPCV)and diastolic blood pressure(nDBPCV).Data were analyzed using SPSS,version 18.0,Continuous data were presented as mean ± SD.The chi-square(?2)test was used for nominal data.T text for univariate method.Furthermore,Logistic regression were used to analyze the factors related to the occurrence and development of WMIL.All tests were considered significance if p<0.05.Results:Single factor analysis showed that gender,history of smoking,history of drinking,history of diabetes,history of coronary heart disease,TC,TG,LDL-C,24 hDBP,dDBP,n DBP,nSBP-CV,24hDBP-CV,dDBP-CV,n DBP-CV,24 HR and nHR have no obvious statistical differnece between the low level group and high level group.(p>0.05)(1)Compared with low level group,high level group had significantly higher age and course Hypertension.(2)Compared with low level group,high level group had significantly higher dHR,24 hSBP,d SBP,nSBP,24hSBP-CV and d SBP-CV.Multi-factor analysis showed that age,24hSBP-CV and dSBP-CV are Independent risk factors for progression of WMIL.Conclusions:1.Age and course of hypertension might be correlated with WMIL in elderly hypertension.2.High Systolic Blood Rressure variability might be correlated with WMIL in elderly patients with high blood pressure.