Clinical Observation Of Different Target Values Of Hypotension In Patients With Hypertension

Objective: By comparing different target values of hypotension,we observed their effects on target organs such as heart,brain,kidney and cervical blood vessels,compared different target values of hypotension,observed the occurrence of cardiovascular and cerebrovascular events,and analyzed the influence of blood pressure and other influencing factors on the occurrence of cardiovascular and cerebrovascular events.Methods: From January 2012 to December 2017,he was hospitalized at least twice in Gansu Provincial People's Hospital.The interval between two hospitalizations is at least half a year,and there are 254 patients with essential hypertension who regularly take antihypertensive drugs for at least three months.According to the blood pressure level after antihypertensive treatment,the patients were divided into 130-139/80-89 mmHg group and <130/80 mmHg group.Gender,age,body mass index(BMI),types of antihypertensive drugs,whether taking lipid-lowering drugs and antiplatelet drugs,smokin Course of hypertension,Hospitalization interval,blood pressure level,history,drinking history,family history,biochemical indicators,echocardiographic related indicators,cervical vascular ultrasound and cranial MRI or CT results were recorded.The general clinical data,biochemical indicators,ultrasound indicators,Course of hypertension,Hospitalization interval,blood pressure levels and the occurrence of cardiovascular and cerebrovascular events were compared among the groups.The cardiovascular and cerebrovascular events included non-fatal myocardialinfarction,acute heart failure,acute cerebral infarction,acute cerebral hemorrhage and coronary artery revascularization.Result: There were no significant differences in left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVS),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),left ventricular hypertrophy(LVH),24-hour urinary microalbumin,serum creatinine,glomerular filtration rate,endogenous creatinine clearance rate and carotid plaque between the two groups(P > 0.05).There was significant difference in the target value of hypotension between the two groups(P < 0.05).There were 34 cases of cardiovascular and cerebrovascular events in all patients.Multivariate analysis showed that systolic blood pressure(SBP),age,low density lipoprotein(LDL)and smoking history were risk factors for cardiovascular and cerebrovascular events in hypertension patients with different target values of hypotension,and the difference was statistically significant(P <0.05).Conclusion: There were fewer lacunar cerebral infarction in patients with hypertension whose target value of lowering blood pressure was less than 130/80 mmHg,and low incidence of cardiovascular and cerebrovascular events in patients with hypertension whose target value of lowering blood pressure was less than 130/80 mmHg.