Relationship Between Day-night Rhythm Of Blood Pressure And Carotid Atherosclerosis In The Elderly With Hypertension

Objective : To study the relationship between blood pressure circadian rhythm and carotid atherosclerosis in elderly hypertension patients,Provide a basis for the prevention and treatment of hypertension and target organ damage in the elderly.Methods:We selected 117 elderly hypertensive patients(44 males and 73 females)who came to our hospital for 24-hour(h)Ambulatory Blood Pressure Monitoring(ABPM)from January 2018 to October 2018.According to the results of ABPM,the patients were divided into dipper group(n=24,8 males and 16 females)and abnormal circadian rhythm group(n=93,36 males and 57 females).The abnormal circadian rhythm group includes non-dipper group(n=67,23 males and 44 females),and anti-dipper group(n=26,13 males and 13 females),no ex-dipper patients were observed.All patients underwent ultrasound examinations of carotid arteries,the IMT of the left and right common carotid arteries was measured.Carotid atherosclerosis was graded according to the IMT of the common carotid artery and the degree of narrow of the lumen.Meanwhile,atherosclerosis plaques were detected in both sides.We also measured fasting blood-glucose(FBG),total lipids(total cholesterol,triglycerides),Homocysteine,24-hour mean systolic blood pressure(24 h MSP),24-hour mean diastolic blood pressure(24 h MDP),daytime mean systolic blood pressure(d MSP),and daytime mean diastolic blood pressure(d MDP),nighttime mean systolic blood pressure(n MSP),nighttime mean diastolic blood pressure(n MDP).General data,carotid IMT,carotid atherosclerosis,carotid atherosclerosis,24-hour systolic blood pressure,narrow group,abnormal circadian rhythm group,non-sputum group and sputum group 24-hour diastolic blood pressure,daytime systolic pressure,daytime diastolic blood pressure,nocturnal systolic pressure,and nighttime diastolic blood pressure were compared.The inferior carotid IMT and plaque of the patients in the sputum group,non-sputum group and snoring group were compared.Block incidence and carotid atherosclerosis were compared to explore their differences.The data was sorted using Excel2016,and statistical analysis was performed using SPSS 24.0 software.The measurement data were expressed by ±s.The two groups of measurement data were compared with the normal distribution using the T test.The count data were expressed by the rate.The two sets of count data were compared with the normal distribution using the ?2 test.It was judged to be statistically significant at P < 0.05.Results: The IMT of left and right carotid arteries was significantly thicker,the incidence of plaques was significantly higher,and the carotid atherosclerosis was significantly severer in abnormal blood pressure circadian rhythm group than in dipper group.The nighttime SBP and DBP were significantly higher in anti-dipper group than innon-dipper group.The IMT of left carotid artery was significantly thicker than that of right carotid artery,the incidence of plaques in left carotid artery was significantly higher than that in right carotid artery in non-dipper group and anti-dipper group.Conclusion: Day-night rhythm of blood pressure has significant correlation with carotid atherosclerosis in the elderly with hypertension.And for the first time,it is proved that the circadian rhythm of abnormal blood pressure(non-dipper groups、anti-dipper groups)in elderly hypertensive patients is more obvious than that of the right side.