The Correlation Between Early Blood Pressure Control And Left Ventricular Hypertrophy In Elderly Patients With Hypertension

Objective: Long-term poor blood pressure control will lead to an increase in the incidence of hypertension-mediated organ damage(HMOD).Long-term elevated blood pressure will lead to a sustained increase in cardiac afterload,which will lead to compensatory ventricular hypertrophy and subsequent heart failure.Left ventricular hypertrophy(LVH)caused by hypertension is an important HMOD,and LVH is also an independent risk factor for predicting cardiovascular events.The prevalence of hypertension in the elderly is high,and HMOD is more likely to occur.Traditionally,the hypertension of the elderly blood pressure lowering should be slowly achieved,which is conducive to the protection of heart and brain organs.However,in clinical practice,some hypertensive patients,especially hospitalized patients,met their blood pressure standards within one week after receiving medication.Therefore,the purpose of this study was to investigate the safety of early blood pressure(two-four weeks)control or earlier blood pressure(one week)reach the target in elderly hypertensive patients and the relationship between LVH occurrence and development.Method: This is a prospective study.252 hypertensive patients from November 2016 to August 2017 were enrolled in the outpatient and hospitalized clinics of the three cardiac wards of Landa Second Hospital.All the patients were enrolled in the study.They were examined by medical history collection,height,weight,blood lipid,blood kidney function and blood pressure measurement in the clinic.Following up for one month,the patients were divided into four groups according to the time of blood pressure reaching the standard.They were 58 people reaching the standard within one week,95 people reaching the standard within two-four weeks and 62 people reaching the standard over four weeks.There were 34 people whose blood pressure did not reach the standard for more than four weeks.In the first month after admission,blood pressure was measured seven days a week,twice a day,before getting up at 6:00-9:00 in the morning and 6:00-9:00 in the evening.Blood pressure was measured two-three times at an interval of one minute.For patients who could not insist on continuous blood pressure measurement for one week,blood pressure was measured for at least three consecutive days.During the follow-up period after admission,for those whose blood pressure has been controlled,blood pressure should be measured one-two days a week and twice a day.If the blood pressure does not reach the standard,the number of blood pressure measurements can be increased appropriately,and the anthypertensive drugs can be adjusted according to the blood pressure level to ensure that the blood pressure is kept up to the standard.After one year of follow-up,blood lipid,blood kidney function,echocardiography and ambulatory blood pressure examination were performed to compare the effects of blood pressure at different time on the heart of patients with hypertension.All patients were monitored for longterm blood pressure transmission on the Internet.Result: The left ventricular mass index(LVMI)of the patients who blood pressure controled with one week was lower than that of the patients with blood pressure above four weeks(P < 0.05),There was no differnet of the patients with blood pressure controled with two-four weeks and that of the patients with blood pressure above four weeks in the LVMI.However,It was also no significant difference in LVMI between those who reached the blood pressure standard in one week and those who reached the blood pressure standard in two-four weeks(P > 0.05);the LVMI of those who reached the blood pressure standard in more than four weeks was no differcnce that of those who reached the blood pressure standard in two-four weeks.Compared with those who did not reach the blood pressure standard for more than four weeks,the LVMI of those who met the blood pressure standard within four weeks was lower,and the difference was significant(P < 0.05).Multivariate linear regression analysis showed that the time of blood pressure reaching the target,24 hours systolic blood pressure and nocturnal systolic blood pressure were risk factors for LVH in elderly patients with hypertension.Conclusion: Achieving blood pressure standard in early stage(within one month)can effectively delay the occurrence and development of LVH in hypertensive patients.Beside,The safety of blood pressure reaching the standard within one week is similar to that within one month.There is no dizziness,hypotension and other adverse phenomena.