ABSTRACT
Objective To investigate the characteristics of blood pressure variability during 24 hours and pre-thrombotic state(PTS) in elderly patients with essential hypertension.Methods One hundred cases of old patients with essential hypertension in the department of Cardiology (hypertension group) and 65 controls with normal blood pressure from Punan Health Check Center (control group) were recruited.The systolic and diastolic blood pressure variability (SBPV,DBPV) during 24 h daytime and nighttime were monitored for all subjects by ambulatory blood pressure monitor.The plasma levels of P-selectin (PS),fibrinogen (Fg) and plasminogen activator inhibitor-1 (PAI-1) were measured.Results The systolic blood pressure variability (SBPV) in hypertension group was significantly larger than that of control group (P ＜ 0.05) in daytime,and no significant difference regarding of the diastolic blood pressure variability (DBPV) between two groups.While in nighttime,SBPV and DBPV in hypertension group were significantly higher than those of control group (P ＜ 0.05).The levels of plasma Fg and PAI-1 in hypertension group were significantly higher than those of control group ((2.8 ±0.9) g/L vs.(2.3 ±0.7) g/L and (29.8 ±2.7) μg/L vs.(25.6 ± 1.2) μg/L,respectively).While no significant difference was found between two groups for PS (P ＞ 0.05).Conclusion That indicated pre-thrombotic state including higher blood pressure variability during 24 hours,especially during nighttime in elderly patients with essential hypertension and plasma fibrinogen.
ABSTRACT
Objective To explore the electrophysiological features of triggering atrial premature contraction(APC) in patients with hypertension combined paroxysmal atrial fibrillation (PAf).Metbods The originating sites and prematurity index (PI) of triggering APC were analyzed in 46 PAf patients with hypertension (hypertension group)and in 35 PAf patients without hypertension( non-hypertension group)from April,2008 to March,2011 in Shanghai Punan Hospital of Pudong New District.Results Triggering APCs in 46 cases with hypertension combined PAf in the hypertension group originated mainly in the left atrium( 81.6％ ).The coupling interval (CI)of triggering APC in hypertension group was significantly shorter than that in non-triggering APC ( [ 374.1 ± 31.5 ] ms versus [ 443.6 ± 32.6 ] ms,t =23.361,P ＜ 0.001 ) and that in triggering APC in nonhypertensive group ( [374.1 ±31.5]ms versus [395.7 ±38.2]ms,t =5.549,P ＜0.001 ).PI in triggering APC was lower than that in non-triggering APC in hypertension group(0.50 +0.05 versus 0.63 ±0.06,t =22.544,P ＜ 0.001 ) and that in triggering APC in non-hypertension group (0.50 + 0.05 versus 0.55 ± 0.08,t =5.849,P ＜ 0.001 ).Conclusion The triggering APC in patients with hypertension combined PAf mainly originates in the left atrium,the PI of triggering APC is significantly lower than that in non-hypertension patients with PAf and PAf occurs more easily in patients with hypertension.Prompt measures should be taken for hypertension patients with lower prematurity index to prevent the occurrence of PAf.