To Observe The Changes Of Blood Pressure Variability,circadian Rhythm And Target Organ Damage In Never-treated Hypertensive Patients After 1 Year Of Routine Clinical Practice

Objective: To observe the changes of blood pressure variability,circadian rhythm and target organ damage in patients with essential hypertension after 1 year of routine clinical practice.Methods: From August 2017 to August 2018,100 patients with essential hypertension who were initially diagnosed as having no antihypertensive treatment in the outpatient department or physical examination center of cardiovascular department of Anhui provincial hospital were selected.According to the characteristics of each patient,the appropriate antihypertensive drugs were selected for antihypertensive treatment.According to whether the blood pressure can be reduced to less than 130 / 80 mm Hg within three months,87 patients were divided into the standard group and 13 patients were divided into the non standard group.Before and one year after admission,the general biochemical examination,blood pressure variability,blood pressure circadian rhythm,ankle brachial pulse wave conduction velocity,left ventricular mass index and urinary microalbumin were collected for statistical analysis.Results: After one year,the blood pressure of the standard group and the non standard group could be controlled,the difference was not statistically significant(P > 0.05).Compared with the control group before and after treatment,standard deviation of24-hour systolic pressure(24 h SSD),standard deviation of systolic blood pressure during the day(d SSD),standard deviation of systolic pressure at night(n SSD),ankle brachial pulse wave velocity,left ventricular mass index and urinary microalbumin in the qualified group and the non-qualified group were improved,and the difference was statistically significant(P < 0.05).After treatment,the proportion of spoon blood pressure in the standard group increased significantly(P < 0.05),but there was no significant difference in the proportion of spoon blood pressure in the non standard group(P > 0.05).The improvement of standard deviation of 24-hour systolic pressure(24 h SSD),standard deviation of systolic blood pressure during the day(d SSD),standard deviation of systolic pressure at night(n SSD),spoon type blood pressure ratio,ankle brachial pulse wave conduction velocity,left ventricular mass index and urinary microalbumin in the standard group were significantly higher than those in the non standard group(P < 0.05);after one year,the improvement rate of target organ injury in the standard group was significantly higher than that in the non standard group(P <0.05).Conclusion: After one year of antihypertensive treatment,the variability of blood pressure,circadian rhythm of blood pressure and target organ damage of hypertension patients can be improved,early antihypertensive and early benefit.