To Explore The Value Of Relationship Between Blood Pressure Circadian Rhythm And Hypersensitive C-reactive Protein And Neutrophil To Lymphocyte Levels Of Essential Hypertension In Middle-aged And Elderly Patients

Objective : With the improvement of people's consumption level,the change of diet conditions and living habits,the number of people with hypertension is increasing.Circadian activity of blood pressure is the main manifestation of rhythmic fluctuation of human blood pressure,which has certain protective effect on the function and structure of human organs,but once it changes,it is easy to affect human health.In particular,it can cause serious chronic damage to the target organs.Inflammation plays an important role in the occurrence and development of hypertension.Many inflammatory factors are known to participate in the occurrence of hypertension.Since the relationship between the inflammation and the hypertension is so close,it is possible to help the doctor to predict the fluctuation of the circadian rhythm of the blood pressure of the hypertension patient in clinic,so as to have a reasonable step-down medicine and a reasonable time for taking the medicine.It is helpful to control the abnormal fluctuation of blood pressure in the patients with high blood pressure,especially in the elderly,and to reduce the damage of the target organs.Herefore the ratio of neutrophil to lymphocyte(nlr)and hypersensitive c-reactive protein(hs-crp)were selected to study the relationship between neutrophil-lymphocyte ratio and circadian rhythm of blood pressure in order to serve the clinical work better.Methods:163 patients(3 45 years old)in xx Hospital from October 2017 to September2018 were included in the study.The patients were diagnosed as hypertension in the past.According to the results of 24-hour ambulatory blood pressure,they were divided into dipper group(nocturnal blood pressure drop rate 3 10%)and non-dipper group(nocturnal blood pressure drop rate<10%).According to age,they were divided into three sub-groups: middle-aged group,aged group and advanced age group.Detection of blood routine,biochemical and hs-crp,calculation of nlr in patients.Result:1.The rate of abnormal circadian rhythm was significantly different in different age groups(p<0.05).The incidence of non-dipper type in the elderly group was significantly higher than that in the other two groups.2.The mean diastolic blood pressure(24hDBP),nocturnal mean diastolic pressure(nDBP)and daytime mean diastolic blood pressure(dDBP)in middle-aged and elderly patients with hypertension increased with age and decreased gradually.There was a significant difference between the two groups(p<0.05).There was no significant difference between the 24-hour mean systolic pressure(24hSBP)and the mean-night systolic blood pressure(nSBP)between the two groups(p>0.05).3.There was no significant difference in the middle-aged NLR between dipper group(1.47 ± 0.27)and the non-dipper group(1.69 ± 0.43).However,the dipper group(1.62± 0.23)and the non-dipper group(1.95 ± 0.36)in the elderly group and the dipper group(1.95 ± 0.36)and the non-dipper group(3.1 ± 0.60)nlr in the elderly group were significantly different from those in the advanced age group(p<0.05).There was a significant difference in middle-aged hs-crp between the dipper group(1.04 ± 0.18)and the non-dipper group(1.74 ± 0.41)and the aged group(1.18 ± 0.29)and the non-spoon group(1.85 ± 0.40).The hs-crp of the two types of hypertension rhythm in the aged group was significantly different from that in the middle-aged group and the elderly group(p<0.05).4.multi-factor regression analysis:NLR,hs-crp is an independent risk factor fornon-dipper hypertension.OR value is 4.659 and 134.096 respectively.The higher the nlr value or hs-crp value is,the higher the probability of occurrence of non-spoon type is.Conclusion:1.The circadian rhythm of blood pressure in elderly patients with hypertension is related to the increase of NLR.The circadian rhythm of blood pressure in middle-aged and elderly patients with hypertension is related to the increase of hs-crp.2.NLR and hs-crp are independen tinfluencing factor of non-dipper type blood pressure.The higher the value,the higher the probability of the abnormal circadian rhythm of blood pressure.