Circadian Rhythm Of Blood Pressure In Patients With Acute Cerebral Infarction And Its Correlation With Condition And Prognosis

Objectives To investigate the circadian rhythm of blood pressure in patients with acute cerebral infarction and its correlation with the condition and prognosis.Methods A total of 256 patients with acute cerebral infarction who were hospitalized in the Department of Neurology,North China University of Technology Affiliated Hospital from March 2016 to December 2017 were collected.The diagnosis was in line with the diagnostic criteria for acute cerebral infarction in the Chinese Acute Ischemic Stroke Diagnosis and Treatment Guidelines 2014.At the same time,120 patients with noncerebral infarction who were hospitalized were selected as the control group.All patients underwent ambulatory blood pressure monitoring within 72 hours.During the monitoring period,antihypertensive drugs and drugs that affect blood pressure and autonomic function were not used.According to the results of ambulatory blood pressure monitoring,the circadian rhythms of blood pressure in patients in each group were divided into indica type,non-dipper type,super type,and antispasmodic type.To analyze the circadian rhythm of blood pressure in patients with acute cerebral infarction.By comparing the changes in the course of treatment of patients with acute cerebral infarction and NIHSS scores and m RS scores at the time of admission and at the time of March,the correlation between the circadian rhythm of blood pressure and the condition and prognosis was analyzed.Results 1 Of the 256 patients with acute cerebral infarction,91(35.5%)were normal type,40(15.6%)were non-dippers,68(26.6%)were super type,57(22.3%)were retrograde,120 cases were In the control group,there were 61 normal cases(50.8%),nondippers 12 cases(10.0%),30 cases super type(25.0%),and 17 cases(14.2%).There was a statistically significant difference in the circadian rhythm of blood pressure between the two groups(X2=9.391,P=0.026).In the cerebral infarction group,64.5% of patients had abnormal blood pressure circadian rhythm.Abnormal rhythm patterns were dominated by hyperparathyroidism and antispasmodicism.The control group had abnormal circadian rhythm of blood pressure,which accounted for 49.2%.The abnormal rhythm was dominated by hyperparathyroidism.2 Univariate analysis showed that age,male sex,alcohol consumption,total cholesterol,triglyceride,high-density lipoprotein,and uric acid had no effect on blood pressure rhythm(P>0.05).Smoking,body mass index,diabetes,persistent atrial fibrillation,LDL-C,Hey,blood viscosity may have effects on blood pressure rhythm(P<0.05);Multivariate unconditional Logistic regression results suggested that BMI≥24(OR=2.009;95%CI,0.105-2.316;P=0.037),Hypertension with diabetes me llit-us(OR=3.879;95%CI,1.564-6.482;P=0.011),persistent atrial fibrillation(OR= 6.135;95% CI,1.502-24.789;P=0.005),Hcy(OR=1.891;95%CI,1.080-6.582;P=0.030)is a risk factor for abnormal blood pressure rhythm in patients with acute cerebral infarction.3 The rate of disease progression and recurrence rate in the abnormal rhythm group were higher than those in the normal rhythm group(P<0.05).In the aberrant rhythm group,the progression and recurrence rate of the antispasmodic group was higher than that of other groups,and the difference was significant(all P<0.05).4 The NIHSS scores of the anomalous rhythm group and normal rhythm group were(6.72±1.37)points and(6.68±1.42)points,respectively.There was no significant difference(P>0.05).The NIHSS at March were(3.56±1.28)points and(2.69±0.93)points,respectively.The difference was statistically significant(P<0.05).In the aberrant rhythm group,the NIHSS scores of the antispasmodic group at the 3rd month were higher than those of the other groups(P<0.05);the m RS scores of the arrhythmia group and the normal rhythm group at the time of admission were(3.04±0.81).(3.20±1.13)points,the difference was not statistically significant(P>0.05).The m RS scores at March were(1.98±0.848)points,(1.44±0.846)points,and the difference was statistically significant(P<0.05);In the aberrant rhythm group,m RS scores of the antispasmodic group at 3 months were higher than those of other groups,and the difference was statistically significant(P<0.05).Conclusions 1 In patients with acute cerebral infarction,the circadian rhythm of abnormal blood pressure is more common in patients with hyperparathyroidism and antispasia.2 BMI≥24,persistent atrial fibrillation,diabetes mellitus,hyperhomocysteine are risk factors for abnormal blood pressure circadian rhythm.3 The change of circadian rhythm of blood pressure is related to the change of condition and prognosis of patients with acute cerebral infarction.The patients with abnormal rhythm have high disease progression and recurrence rate and poor prognosis,among which patients with antispasmodic type are more obvious.