ABSTRACT
Objective To investigate the effect of depression on morning blood pressure surge ( MBPS) in maintenance hemodialysis( MHD) patients with hypertension. Methods 67 MHD patients with hypertension were included in this study.All clinical data were collected,and ambulatory blood pressure mo-nitor was used to monitor patient''''''''s blood pressure in 24 hours.Self-rating depression scale(SDS) was used to survey 67 MHD patients,and multivariable logistic regression was conducted to determine independent risk factors for morning hypertension in MHD patients with hypertension. Results There were 14 depression pa-tients in non-morning hypertension group ( 35. 0％) , 18 depression patients in morning hypertension group (66.7％),and the difference was significant(χ2=6.479,P=0.011).In addition correlation analysis showed that age(r=0.027,P=0.044),24 h systolic pressure(r=0.284,P=0.020),24 h diastolic pressure(r=0.278,P=0.023),fasting blood-glucose (r=0.293,P=0.039),low-density lipoprotein cholesterol (r=0.345,P=0.016),and the standard score of SDS(r=0. 276,P=0.024)were significantly correlated with MBPS .Furthermore,multivariable logistic regression showed that the standard score of SDS(OR=1.101,95％CI=1.018-1.191,P=0.016) ,24 h diastolic pressure ( OR=1.070,95％CI=1.007-1.136,P=0.028) and fast-ing blood-glucose (OR=2.127,95％CI=1.118-4.049,P=0.022)were independent risk factors for morning hypertension in MHD patients with hypertension ( OR=1. 101, 95％CI:1. 018-1. 191, P=0. 016 ) . Conclu-sion Depression,24 h diastolic pressure and fasting blood-glucose can increase the risk of morning blood pressure surge in patients with MHD hypertension.
ABSTRACT
Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.
ABSTRACT
Objective To explore the effect of long-term alcohol consumption on morning blood pressure surge (MBPS) and its association with left ventricular hypertrophy (LVH) in males with hypertension. Methods According to the findings of our questionnaire survey, 199 male patients with hypertension were divided into non-drinking, giving up drinking and mild, moderate and heavy drinking groups. The fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), heart rate (HR) and body mass index (BMI) were examined in all patients. The 24-hour ambulatory blood pressure monitoring and echocardiography were performed and the left ventricular mass index (LVMI) were calculated. The data were analyzed by using SPSS 10.0 software. Results The FPG, TC, TG, HDL,LDL HR, BMI and other parameters had no significant differences among the 5 groups (P>0. 05). The levels of 24- hour mean systolic blood pressure(24h SBP), daytime mean systolic blood pressure (dSBP) and nighttime mean systolic blood pressure(nSBP) in the non-drinking, giving up drinking and mild drinking groups were significantly lower than those in the moderate and heavy drinking groups (P0. 05). The average daily alcohol consumption was positively correlated with MBPS value andLVMI in the moderate and heavy drinking groups (P<0. 05). Conclusion Long-term moderate and heavy drinking can affect the circadian rhythm of blood pressure, and aggravate MBPS and LVH in males with hypertension. The MBPS and degree of LVH increase with the increase in alcohol consumption.
ABSTRACT
OBJECTIVE: To evaluate the effects of domestic olmesartan medoxomil tablets on 24 h ambulatory blood pressure, morning blood pressure surge (MBPS), and blood pressure at 6 h after dosing in patients with mild to moderate hypertension. METHODS: A randomized, double-blind, double-mimic controlled trial was performed. Forty-eight patients were randomly assigned to treatment group (domestic olmesartan tablets) or control group (Olmetec). The 24 h ambulatory blood pressure was monitored at the end of the trial. RESULTS: The mean 24 h systolic/diastolic blood pressures of the treatment and control groups were significantly reduced by (8.8 ± 3.0)/(10.8 ± 2.8) mmHg and (8.9 ± 4.0)/(9.2 ± 5.2) mmHg, respectively, and the mean systolic/diastolic blood pressure at 6 h after dosing significantly reduced by (10.5 ± 10.9)/(12.2 ± 8.1) and (11.2 ± 8.4)/(12.6 ± 8.5) mmHg, respectively, with no significant differences between the two groups. In both groups, the MBPS was significantly reduced after treatment (from (31.3 ± 10.2) mmHg to (20.3 ± 9.2) mmHg and (33.4 ± 13.1) mmHg to (24.1 ± 10.4) mmHg, respectively). CONCLUSION: Administration of domestic olmesartan medoxomil tablets once daily can significantly reduce 24 h blood pressure, morning blood surge and blood pressure at 6 h after dosing in patients with mild to moderate essential hypertension.
ABSTRACT
Objective To evaluate the effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge in patients with essential hypertension. Methods Ninety patients with essential hypertension were randomly divided into irbesartan group ( group A, n = 45) and nifedipine group (group B, n =45). Irbesartan tablets 150 mg/d and nifedipine controlled-release tablets 30 mg/d were respectively given in group A and group B for 4 weeks. The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure ( MAP ) and morning blood pressure surge ( MBPS ) before and after treatment were measured by ambulatory blood pressure monitoring. Results The DBP, SBP, MAP and MBPS levels of two groups after treatment for 4 weeks were all decreased (P < 0.01). All the indexes of group B decreased more significant compared to group A (P < 0.05 ). Conclusion To control blood pressure and prevent morning blood pressure surge, nifedipine controlled-release tablets are better than irbesartan.
ABSTRACT
Objective To explore the relationship between asymptomatic lacunar cerebral infarction and blood pressure variability (BPV) in senile patients with essential hypertension.Methods According to the results of the cranial magnetic resonance imaging (MRI),160 patients were divided into two groups:96 cases of hypertension combined with lacunar cerebral infarction group and 64 cases of simple hypertension group.Their levels and variability blood pressure were investigated by 24 hours ambulatory blood pressure monitoring.All markers included 24 h average systolic blood pressure variation (24 h SBPV),24 h average diastolic blood pressure variation (24 h DBPV),the day average systolic blood pressure variation (dSBPV),the night average systolic blood pressure variation (nSBPV),the day average diastolic blood pressure variation (dDBPV),the night average diastolic blood pressure variation (nDBPV),the standard deviation (SD)and variable coefficient (CV) of morning peak systolic blood pressure and diastolic blood pressure.Results 24 h SBPV,dSBPV,nSBPV,24 h DBPV,dDBPV,nDBPV was increased significantly in hypertension combined with lacunar cerebral infarction group compared with those in simple hypertension group (0.15±0.03 vs.0.11 ± 0.02,0.14 ± 0.02 vs.0.10 ± 0.03,0.14 ± 0.03 vs.0.10 ± 0.08,0.13 ± 0.08 vs.0.11 ±0.04,0.14 ±0.02 vs.0.11 ±0.07,0.14 ±0.05 vs.0.09 ±0.02),and there was significant difference (P ＜ 0.05).SD and CV of morning peak systolic blood pressure and diastolic blood pressure in hypertension combined with lacunar cerebral infarction group was higher than that in simple hypertension group [(15.37 ±4.55) mmHg (1 mmHg =0.133 kPa) vs.(13.53 ±2.26) mmHg,(13.64 ±4.95) mmHg vs.(9.80 ± 3.46) mmHg,0.141 ± 0.048 vs.0.113 ± 0.037,0.145 ± 0.056 vs.0.105 ± 0.036],and there was significant difference(P ＜ 0.05).Conclusion The BPV,especially morning blood pressure surge BPV are increased significantly in the hypertension combined with lacunar cerebral infarction group compared with that simple hypertension group,BPV increase is one of the important risk factors of cerebral infarction.
ABSTRACT
Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients. Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording. Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.
ABSTRACT
Objective To explore the relationship between the level of morning blood pressure surge (MBPS) and High-sensitivity C-reactive protein( hs-CRP) in acute coronary events among old patients and to evaluate their clinical value. Methods One hundred and twenty - three patients with coronary disease were divided into two groups, each of which was old myocardial infarction(OMI, n = 55) and old myocardial infarction with acute cardiovascular syndrome (OMI + ACS, n =68). The control group includes the patients without coronary disease( n =50). The patients who have infection, malignant tumors, liver and kidney dysfunction, blood diseases, valvular heart diseases, congenital heart diseases, aortic dissection,secondary hypertension were not included. All groups were received 24 hours ambulatory blood pressure monitoring to calculate MBPS and the determination of hs-CRP in serum. Results Compared with each two groups, the levels of MBPS and hs-CRP in OMI group were significantly higher than those of the control group (0. 01 ＜ P ＜0. 05) , and had more significance in the other groups ( P ＜0.01). The levels of MBPS and hs-CRP had positive relationship in coronary events in the elderly ( r =0. 76, P ＜0. 01) . Conclusion The level of MBPS is positively correlated with serum hs-CRP which is one of key risk factors of inflammatory reactions by impairing vessels in body. The two factors both play important roles in the occurrence and the development of coronary events among old patients. They both have important clinical value in recurrent acute coronary events among old patients.
ABSTRACT
Objective To investigate the association between morniing blood pressure surge (MBPS) and carotid atherosclerosis in elder patients with essential hypertension. Methods According to the results of24h ambulatory blood pressure monitoring, 106 patients were classified as the morning BP surge group (MBPS group,n = 58) ,and nonsurge group (NMBPS group, n = 48). Patients underwent carotid ultrasound and the intima-medial thickness (CCA-IMT) and plaques were examined. Results The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group[(1.27 ± 0. 12)mm vs (0.92 ± 0.33 )mm], P ＜ 0. 05 ) ;②Compared with the NMBPS group,the severity of carotid arteries plaque of the MBPS group was significantly higher (72. 15% vs 54.21% ), ( P ＜0. 01 ) ;③Pearson relation analysis showed CCA-IMT level positively correlated with age (r = 0.288, P ＜ 0.001 ) ,the average of 24h SBP ( r = 0. 768 ,P ＜ 0. 001 ), and MBPS ( r = 0. 768, P ＜ 0.001 ). Conclusion The study showed that MBPS was closely related with carotid atherosclerosis in elder patients with essential hypertension and was an important risk factor in the process of atheresclerosis.
ABSTRACT
Objective To investigate the influence of irbesartan taken before bedtime on morning blood pressure surge and urine microalbuminuria in elderly patients with essential hypertension. Methods Ninety-two patients with uncontrolled hypertension were recruited in this study and their 24-hour ambulatory blood pressure monitoring profiles were collected for analysis. After irbesartan taken before bedtime, its influence on general blood pressure, morning blood pressure surge and urine microalbuminuria was observed. Results Before irbesartan treatment,the average 24-hour ambulatory blood pressure was(140.1 ± 12. 7)mm Hg, the morning blood pressure surge was (45.6 ± 10.8) mm Hg, urine microalbuminuria level was (58.6 ± 3.7) mg/L. After irbesartan treatment,the average 24-hour ambulatory blood pressure decreased to (129. 5 t 11.8) mm Hg (t = 3.18, P ＜ 0.05), the morning blood pressure surge decreased to(14. 2 ±4. 1)mm Hg(t =5.74,P ＜0.01) ,urine microalbuminuria level decreased to(31.7±3.1)mg/L(t =5.24,P＜0.01).Conclusions Irbesartan can effectively reduce the peak morning blood pressure,improve achievement ratio of blood pressure control, decrease urine microalbuminuria level in elderly patients essential hypertension.
ABSTRACT
@#ObjectiveTo investigate the relation between morning blood pressure surge(MBPS) and myocardial ischemia.Methods315 patients with primary hypertension and coronary heart disease were received Holter and non-invasive ambulatory blood pressure monitoring(ABPM). According to the morning blood pressure raised, they were divided into MBPS group and no-MBPS group. Then the ABPM and Holter data were compared.ResultsThe patients in MBPS group were older. The myocardial ischemia events were more common in MBPS group than in no-MBPS group. The logistic regress showed that the MBPS was related to myocardial ischemia events even after corrected by age, smoke, and sex.ConclusionMBPS is a risk factor of myocardial ischemia.
ABSTRACT
Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.
ABSTRACT
Objective To investigate the association between the target organ damage and morning blood pres- sure surge(MBPS) in the elderly hypertensives.Methods Three hundred thirty-two patients submitted to 24 h ambulatory blood pressure monitoring were categorized as with MBPS (n=173),and non-MBPS(n=149).Total cholesterol,body mass index(BMI),left ventricular mass index (LVMI),carotid endothelial medium thickness (CCA-IMT and ICA-IMT) and corrected QT dispersion(QTcd) were determined.Results 24 h,day and night mean systolic blood pressure in MBPS group were significantly higher than that in the non-MBPS group(P
ABSTRACT
Objective To investigate the association between morning blood pressure surge(MBPS) and carotid atherosclerosis in patients with essential hypertension.Methods According to the results of 24 h ambulatory blood pressure monitoring,137 patients were classified as the morning BP surge group(MBPS group,n=75),and non-surge group(NMBPS group,n=62).Patients underwent carotid ultrasound and the intima-medial thickness(CCA-IMT) and plaques were examined.Results ① The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group [CCA-IMT,MBPS group(1.34?0.13) mm vs NMBPS group(0.98?0.43) mm,P
ABSTRACT
Objective To investigate the association between morning blood pressure surge(MBPS)and the ambulatory blood pressure monitoring parameters on carotid artery intima-media thickness(IMT)in hypertensive patients.Methods Based on the occurrence of MBPS two hundred twenty six hypertensive patients were allocated as MBPS(n=51)or non-MBPS(n=175).However,based on the IMT,226 patients were stratified as IMT increased(n=94)or group normal IMT(n=132).Plasma lipids,24 h ambulatory blood pressure monitoring(ABPM)and ultrasound examinations of the IMT of carotid arteries were determined.Results 1)The value of MBPS,mean arterial pressure(MAP),morning pulse pressure(MPP),carotid artery IMT,carotid artery crouse score in MBPS group were significantly higher than that in no MBPS groups(P