Correlation Between Morning Blood Pressure Surge And Left Ventricular Hypertrophy And Carotid Intima-media Thickness In Elderly Patients With Essential Hypertension

Objective: To explore the correlation between morning blood pressure surge and LVH and C-IMT in elderly patients with essential hypertension.Methods: we prospectively included 298 inpatients(age>65 years,male 152 and mean age 70.42±2.91 years,female 146 and mean age 69.76±2.79 years)with essential hypertension,and were hospitalized in the Second Hospital of Dalian Medical University from January 2015 to December 2015,those patients who with secondary hypertension,severe infections or other severe diseases were excluded from the study.Physical examination and antihypertensive treatments were recorded.Laboratory data and twenty-four-hour ambulatory blood pressure monitoring(ABPM)was performed.Left ventricular mass index(LVMI)and bi-carotid intima-media thickness were measured by B-mode ultrasonography.Patients were categorized into two groups: the morning blood pressure surge(MBPS)group(n=150,and mean age 73.02±6.91 years)whose morning blood pressure level was more than 35 mm Hg and non-morning blood pressure surge group(n=148,and mean age 70.76±8.02 years)whose morning blood pressure level was less than 35 mm Hg.Results: The level of blood total cholesterol(TC=5.09 ± 0.88mmol/L),Low density lipoprotein-cholesterol(LDL-C=3.23 ± 0.76 mmol/L)of morning blood pressure surge group is higher than those of non-morning pressure surge group(respectively 4.36 ±0.79mmol/L,2.74±0.81 mmol/L),the difference betweenthe two groups was significant(P<0.05).In MBPS group,24 h ambulatory systolic blood pressure(SBP),daytime ambulatory SBP,nighttime ambulatory SBP,24 h ambulatory pulse pressure(PP),daytime ambulatory PP,nighttime ambulatory PP,LVMI and C-IMT were all significantly higher than those in non-MBPS group(P<0.05).Conclusion: TC and LDL-C are possibly risk factors of MBPS phenomenon.The MBPS phenomenon may be a sign of the left ventricular hypertrophy and carotid intima-media thickness in eldly patients with essential hypertension.