The Relationship Between The Blood Homocysteine Level,Blood Pressure Variability And Atherosclerosis In Patients With Primary Hypertension

Objective:To explore the relationship between the blood homocysteine level,blood pressure variability and atherosclerosis in patients with primary hypertension,providing the foundation for optimal treatment of hypertension and the prevention of the resulting target organ damage.Methods:The study involved 90 cases of patients with primary hypertension in the Second Affiliated Hospital of Shanxi Medical University between January 2016 and January 2017,and according to the blood homocysteine levels,cases were divided into three groups: the normal group(Hcy < 10 umol/L),the low level group(10-20 umol/L),the high level group(Hcy > 20 umol/L).All patients received examinations of 24 hour ambulatory blood pressure and carotid-femoral pulse wave velocity(cfPWV).Comparison of the blood pressure variability(using blood pressure standard deviation and coefficient of variation),detection rate of non dipper type blood pressure and atherosclerosis between the three groups,Screening independent impact factors of atherosclerosis.Results:24 hour ambulatory blood pressure results showed: the 24-hour systolic blood pressure standard deviation(24 hSSD),daytime systolic blood pressure standard deviation(dSSD),nighttime systolic blood pressure standard deviation(nSSD),24 hours of systolic blood pressure variation coefficient(24hSCV),daytime systolic blood pressure variation coefficient(dSCV),daytime diastolic blood pressure variation coefficient(dDCV)and nighttime systolic blood pressure variation coefficient(nSCV)in low level group and highlevel group all raised than normal group(P<0.05).Compared with the low level group,24 hSSD,dSSD,nSSD,24 hSCV,dSCV,dDCV,nSCV in high level group were increased(P < 0.05).The detection rate of non dipper type blood pressure in high level group was higer than that in normal group and low level group,difference was statistically significant(P<0.01).The detection rate of non dipper type blood pressure in high level group was higer than that in low level group,but difference was not statistically significant(P>0.05).Detection rate of arteriosclerosis in low and high level group were higher than that in normal group(P<0.01).Detection rate of arteriosclerosis in the high level group was higher than that in low level group(P < 0.01).Correlation analysis results showed: Serum Hcy level was positive correlated with 24 hSSD,dSSD,nSSD,24 hSCV,dSCV,dDCV.cfPWV was positive correlated with 24 hSSD,dSSD,dSCV and nSCV.Logistic regression analysis showed that 24 hSSD,nSCV and Hcy were independently related to atherosclerosis.Conclusion:1.With the increasing of Hcy levels,BVP and blood pressure circadian rhythm disorders in patients with primary hypertension were more obivous,and the detection rate of non dipper type blood pressure and abnormal of cfPWV were all significantly increased,the degree of arteriosclerosis was more serious.2.Hcy levels and BVP lead to atherosclerosis have a synergistic effect.