ABSTRACT
Objective To analyze the epidemiological characteristics of morning hypertension in people with eseential hypertension in Dali Bai autonomous prefecture,and to study the management model for morning hypertension. Methods From May 2015 to January 2017,302 patients with hypertension in the People's Hospital of Dali Bai Autonomous Prefecture were divided voluntarily into two groups,including single management group (group 1)and systematic management group (group 2 ).During six to twelve months follow －up,the changes in control rate of morning hypertension,serum biochemical indicators,KAP and Mofisky score were observed before and after intervention. Results The proportion of morning hypertension in people with hypertension was 62.25%,61.11% in men and 62.86%in females.The patients with morning hypertension had higher age,BMI,WC,TC,LDL－C,SBP,DBP,CRP, FBG,SCr,Sokolow－Lyon,Cornell,LVMI,UACR and MAU,more cervical plaque,and lower HDL －C and eGFR compared with non－morning hypertension(P＜0.05 －0.001).The number of patients with target organ damage was most in patients with morning hypertension by home blood pressure monitoring(HBPM),second in ambulatory blood pressure monitoring(ABPM),least in clinic blood pressure monitoring (CBPM)(P＜0.05 －0.001).After six to twelve months follow－up,compared with before intervention,the control rate of morning hypertension was increased (43.78%vs.61.39%),and SBP,DBP,HR,BMI,WC,TC,TG,UA,Scr were decreased in both two groups,which in the group 2 were lower than those in the group 1(P＜0.05 ).Compared with before intervention,the KAP score and Mofisky in the two groups after intervention were significantly improved(P＜0.05－0.01)[K score:(9.63 ±3.01)points vs.(14.26 ±2.89)points in the group 1,(10.11±2.34)points vs.(17.23 ±1.06)points in the group2;A score:(2.05 ±1.21)points vs.(2.98 ±0.25)points in the group 1,(2.08 ±1.65)points vs.(3.56 ±0.42)points in the group 2,P score:(4.39 ±2.36)points vs.(5.89 ±3.24)points in the group 1,(4.71±3.42)points vs.(7.26 ± 1.21)points in the group 2,Mofisky questionnaire score:(61.23 ±5.79)points vs.(72.36 ±6.18)points in the group 1,(60.89 ±6.47)points vs.(88.45 ±5.48)points in the group 2],which in the group 2 were higher than those in the group 1(P＜0.01).Conclusion The control rate of morning hypertension in patients with hypertension in Dali Bai autonomous prefecture is low,the HBPM is better way to predict the target organ damage,and systematic management model is effective to improve the control rate of morning hypertension and so do in KAP and Morisky score.
ABSTRACT
Objective To study the relationship between carotid atherosclerosis (CAS) and serum markers in elderly essential hypertension (EH) patients.Methods Three hundred and eightyeight elderly EH patients who underwent carotid colour ultrasonography and biochemical testing served as an EH group and 82 subjects undergoing physical examination served as a control group.The patients in EH group were divided into plaque-free group (n =142),stable plaque group (n=132),and unstable plaque group (n=114).The relationship between CAS and serum FPG,Hcy,TBIL,DBIL,IBIL,UA,ferritin,fibrinogen,CRP levels was analyzed.Results The incidence of CAS and serum Hcy level were significantly higher in EH group than in control group (63.40％ vs 31.71％,12.69±3.58 μmol/L vs 6.96±2.89 μmol/L,P＜0.01).The incidence of CAS was 63.40％ in EH patients.The serum levels of FPG,TC,TG,LDL-C,Hcy,UA,ferritin,fibrinogen,CRP were significantly higher while those of TBIL,DBIL,and IBIL were significantly lower in stable plaque group than in unstable plaque group (P＜0.05,P＜0.01).Logistic regression analysis showed that stable CAS was negatively related with serum levels of TBIL and IBIL and positively related with those of FPG,TC,LDL-C,Hcy,UA,ferritin,fibrinogen and CRP,history of smoking,incidence of DM and hypertension (P＜0.05).Conclusion Serum levels of TBIL and IBIL are the protective factor for CAS while those of FPG,Hcy,UA,ferritin,fibrinogen and CRP are the risk factors for CAS in elderly EH patients.
ABSTRACT
Objective To compare the prevalence and clinical charecteristics of metabolic syndrome(MS) in aged people of Dali Bai Autonomous Prefecture under three diagnostic criteria.Methods A total of 1 386 patients in outpatient department or admitted to our hospital were recruited.The different prevalences under the World Health Organization(WHO) in 1999,the China Diabetes Society in 2004 (CDS 2004) and the China Diabetes Society in 2013(CDS 2013) definitions respectively were calculated and the results were compared by κ test.Results The prevalences of metabolic syndrome under WHO,CDS2004,and CDS2013 were 30.38％,33.77％ and 36.87％,respectively,it increased with age,and was most highest in ＞ 70～ 80 years aged group (P ＜ 0.05-0.01),the number of hypertension abnormality was more than 60.00％,and the most combination of abnormalities ＞ 3 in MS was hypertension + hyperglycemia + obesity (P ＜ 0.01);The 92.86％ concordance of MS cases was found between CDS2004 and CDS2013,90.19％ between WHO and CDS2013,and 80.23％ between WHO and CDS2013 (P ＜ 0.05-0.01).Conclusion The prevalence of MS increased with age in eldely people of Dali Bai Autonomous Prefecture,there is different between man and female,hypertension is the common abnormality in components of MS.The agreement among three criterias is relatively high,and the prevalence of MS has high level by CDS2013.