Correlation Of Impaired Glucose Regulation,Ankle Brachial Index And Blood Pressure Variability In Patients With Hypertension

With the change of life style and the further improvement of living standard,hypertension and diabetes have gradually become an important risk factor for cardiovascular health.The study found that the prevalence of diabetes in Chinese hypertensive population is about 18%.Hypertension patients are mostly accompanied by abnormal glucose tolerance.For such patients,the control standard of blood pressure and blood sugar is more stringent than that of normal people.With the increasing application of 24 h ambulatory blood pressure monitoring(ABPM)in clinical practice,the close relationship between blood pressure variability and BPV and target organ damage has been paid more and more attention.The study found a change in the rhythm of blood pressure in the stage of impaired glucose regulation(IGR).There is a certain correlation between blood pressure variability and vascular atherosclerosis.Ankle brachial index ABI(ankle brachial index)is a commonly used index for detecting arteriosclerosis of lower extremities.Research has confirmed that ABI has a specificity of 99% for peripheral atherosclerosis.Therefore,the correlation of abnormal glucose regulation,ankle brachial index and blood pressure variability in patients with hypertension was investigated,and the relationship between blood glucose level and ABI and BPV in IGR patients was analyzed.Early detection of IGR and ABI in hypertensive patients and active intervention are of great clinical significance in improving blood pressure variability,early prevention and treatment of atherosclerosis and related target organ damage.Objective:To investigate the correlation between IGR and ABI in patients with hypertension and BPV,analyze the relationship between the blood glucose level in patients with hypertension combined with IGR and ABI and BPV,for patients with hypertension early screening showed that IGR and ABI anomalies and positive intervention,so as to improve the blood pressure variability,to provide clinical basis for early prevention and treatment of atherosclerosis and high blood pressure and target organ damage.Methods:Hypertensive patients selected in May 2016 to May 2017 in hospital medical department of the Department of our hospital:1 All patients were tested for fasting blood glucose in the early morning.According to oral glucose tolerance test(OGTT),41 cases were divided into group IFG(group A),42 cases in group IGT(group B),40 cases in group IFG+IGT(group C),and 46 patients with normal glucose tolerance(NGT)as control group(group D).The selected patients were in accordance with the diagnostic criteria.2 ABI measurement: The ABI was calculated by the ratio of the ratio of the dorsiflexion pressure of the dorsal artery to the systolic pressure of the brachial artery using a British Hunter's RD2 Doppler ultrasound flowmeter and divided into groups ABI<0.9 and ABI>0.9.3 We recorded the general situation of patients,including gender,age,weight and history of hypertension.We recorded the high oil,three fat,total cholesterol,glycosylated hemoglobin and other biochemical indicators.4 The patients in the group carried the portable ABPM,and monitored the 24 hour ambulatory blood pressure monitoring and recorded the corresponding values.5 Count data with [n(%)] said,with ?2 test;positive measurement data of normal distribution and homogeneity of variance with x ±s,the four groups were compared by single factor variance analysis,the data of the two groups were compared using t test,ABI analysis and the related factors using multiple linear return regression analysis,all data are used SPSS19.0 statistical software for data analysis,using P<0.05 as the difference was statistically significant.Results:1 Compared with the basic data of the control group,the body weight,age,sex,diastolic pressure,systolic pressure,history of hypertension and family history were not statistically significant(P>0.05).Compared with group D,the levels of triglyceride(TG),total cholesterol(TC),and glycosylated hemoglobin(Hb Alc)in group A,B,and C were significantly higher(P<0.05);Compared with group B and group D,the fasting plasma glucose(FPG)in group A and group C was higher(P<0.05);Compared with group A and group C,2h PBG in group B and group D was higher,the difference was statistically significant(P<0.05).2 The comparison between blood glucose and blood pressure variability indicators: 24 hours of mean diastolic blood pressure variation(24 hm DBPCV)and 24-hour mean systolic blood pressure coefficient(24 hm SBPCV)increase in group A,group B,and group C were significantly higher than those in group D(P<0.05),the mean systolic blood pressure coefficient(24hm SBPCV)of group C was significantly higher than that of group A and B(P<0.01).3 Logistic regression analysis showed that the age of patients with ABI<0.9,the course of hypertension,glycated hemoglobin,24 h SBPV,24 h DBPV,and ABI>0.9 group were higher(P<0.01).4 Taking 24 h SBPCV as dependent variable and remaining variables as independent variables,a regression model was established.It was calculated that 24 h SBPCV was positively correlated with TC,TG,Hb Alc,age,and duration of hypertension,and negatively correlated with ABI.Taking 24 h DBPCV as dependent variable and remaining variables as independent variables,a regression model was established,which was positively correlated with TC,TG,Hb Alc,age,and duration of hypertension,and negatively correlated with ABI.Conclusion:1 Hypertension combined with IGR is an important factor leading to the increase of blood pressure variability,which plays an important role in target organ damage in hypertensive patients.2 Age,the course of hypertension,glycosylated hemoglobin and abnormal blood pressure variability are the risk factors that lead to the decline of ABI.