Effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly / 中国医师杂志

Objectives:To investigate the effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly.Methods:349 elderly people aged ≥60 who underwent 24-hour ambulatory blood pressure monitoring in Gaomi Municipal Hospital from April 2018 to October 2019 were selected to detect brachial artery flow mediated vasodilation (FMD) and chronic inflammatory factors [high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-17] levels. According to the results of 24-hour ambulatory blood pressure monitoring, the subjects were divided into normal blood pressure group ( n=108), simple morning hypertension group ( n=114) and hypertension group ( n=127). The clinical data, 24-hour ambulatory blood pressure parameters, vascular endothelial function and inflammatory factors of the three groups were compared. The correlation between 24-hour ambulatory blood pressure parameters and FMD and inflammatory factors was analyzed by partial correlation. Results:Compared with the normal blood pressure group, the simple morning hypertension group and the hypertension group had lower FMD (all P<0.05), higher serum hsCRP and TNF-α , IL-17 levels (all P<0.05). Compared with the simple morning hypertension group, the hypertension group had lower FMD ( P<0.05), higher serum hsCRP, TNF-α and IL-17 levels (all P<0.05). After controlling for age, sex, smoking history, drinking history, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and 24 h average blood pressure, the morning systolic blood pressure was negatively correlated with FMD ( P<0.05), and positively correlated with serum hsCRP and TNF-α and IL-17 levels (all P<0.05); the morning diastolic blood pressure was negatively correlated with FMD ( P<0.05) and positively correlated with serum hsCRP and TNF-α levels (all P<0.05). Conclusions:Morning blood pressure level is closely related to vascular endothelial function and chronic inflammation level, and is independent of 24-hour average blood pressure. The increase of morning blood pressure may be an important risk factor for endothelial dysfunction and chronic inflammation in the elderly.

Effect of Tiaoshen Qianyang acupuncture on blood pressure and sleep quality in patients with stroke-related sleep disorders complicated with hypertension / 中国针灸

OBJECTIVE@#To observe the effect of Tiaoshen Qianyang acupuncture on morning blood pressure, sleep quality and post-stroke nerve function recovery in patients with stroke-related sleep disorders (SSD) complicated with hypertension.@*METHODS@#A total of 120 patients were randomized into an observation group (60 cases) and a control group (60 cases, 1 case dropped off). Both groups were treated with Xingnao Kaiqiao acupuncture (Neiguan [PC 6], Shuigou [GV 26], Sanyinjiao [SP 6], Jiquan [HT 1], Chize [LU 5] and Weizhong [BL 40]). In addition, Tiaoshen Qianyang acupuncture was applied in the observation group, deep needling at Baihui (GV 20) and Sishencong (EX-HN 1) for 5 h. Once a day, 5 times a week, 30 times in total. The morning blood pressure was measured during treatment in the two groups, the Pittsburgh sleep quality index (PSQI) and National Institute of Health stroke scale (NIHSS) scores before and after treatment were observed in the two groups.@*RESULTS@#Compared before treatment, the morning systolic blood pressure (SBP) after treatment were decreased in the two groups (P<0.05), and the morning diastolic blood pressure (DBP) after treatment was decreased in the observation group (P<0.05). The levels of SBP and DBP after treatment in the observation group were lower than the control group (P<0.05). Compared before treatment, the total score of PSQI and NIHSS score after treatment in the observation group were decreased (P<0.01, P<0.05), which were lower than the control group (P<0.01, P<0.05), the decreasing rate of NIHSS score in the observation group was higher than the control group (P<0.05).@*CONCLUSION@#On the basis of Xingnao Kaiqiao acupuncture, Tiaoshen Qianyang acupuncture could improve morning blood pressure and sleep quality for patients with SSD complicated with hypertension, promote the recovery of nerve function.

Association between glycated hemoglobin and ambulatory blood pressure or heart rate in hypertensive patients / 中南大学学报(医学版)

OBJECTIVES@#To determine the association between glycosylated hemoglobin (HbA1c) and ambulatory blood pressure or heart rate in hypertensive patients.@*METHODS@#A total of 585 patients, who performed ambulatory blood pressure monitoring (ABPM) from September 2018 to April 2019 in Xiangya Hospital, Central South University, were enrolled and assigned into 2 groups (470 in a hypertensive group and 115 in a normal group). HbA1c levels were compared. According to the HbA1c level, the hypertensive group was divided into 2 subgroups: A high HbA1c group (HbA1c≥6.1%, @*RESULTS@#The hypertensive group had higher HbA1c level than the normal group [(6.1±1.3)% vs (5.1±1.7)%, @*CONCLUSIONS@#In hypertensive patients, HbA1c is positively correlated with ambulate blood pressure, blood pressure load, and heart rate, and it has no correlation with blood pressure variability, heart rate variability, or morning blood pressure.

Effect of acupuncture at Renying (ST 9) on blood pressure in patients with ischemic stroke complicated with essential hypertension / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension.@*METHODS@#A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups.@*RESULTS@#Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all 0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all <0.05).@*CONCLUSION@#On the basis of acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.

Effect of " acupuncture" auxiliary therapy on morning blood pressure and blood pressure load in elderly patients with stroke complicated with hypertension / 中国针灸

OBJECTIVE@#To observe the effects of " acupuncture" auxiliary therapy on neurological function, blood pressure load and morning blood pressure in elderly patients with stroke complicated with hypertension, on the basis of " acupuncture" combined with nifedipine.@*METHODS@#Seventy patients with stroke complicated with hypertension were randomly divided into an observation group and a control group, 35 cases in each group. " acupuncture" and conventional nifedipine controlled release tablets were given in the control group. Regarding regaining consciousness with acupuncture, the main acupoint is Shuigou (GV 26), combined with Neiguan (PC 6) and Sanyinjiao (SP 6), retaining needle for 20 min, additionally, the quick needling technique was applied to Shangjiquan (Extra), Chize (LU 5) and Weizhong (BL 40) of the affected side, nifedipine controlled release tablets were orally administered 30 mg once a day for a total of 6 weeks. The " acupuncture" was added on the basis treatment in the observation group, the acupuncture was applied at Renying (ST 9) as the main acupoint, combined with Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). The strict manipulation quantitative acupuncture was used and the needle was retained for 20 min. Both acupuncture methods were performed once a day, 5 times a week, and continued treatment at intervals of 2 days, 10 times for one course, and a total of 3 courses were needed. The morning blood pressure and 24 h blood pressure load were measured before and after treatment. The National Institute of Health stroke scale (NIHSS) score and the Barthel index (BI) classification were observed before and after treatment.@*RESULTS@#The systolic and diastolic blood pressures were significantly lower than those before treatment in the two groups (all 0.05), and the difference of the diastolic blood pressure before and after treatment in the observation group was higher than that in the control group (<0.01). The systolic and diastolic pressures load in the two groups were lower than those before treatment (all <0.01), and the systolic and diastolic pressures load in the observation group were lower than those in the control group (both <0.05), the difference of systolic and diastolic pressure load before and after treatment in the observation group were higher than those in the control group (both <0.05). After treatment, the NIHSS scores in the two groups were lower than those before treatment (both <0.01). The NIHSS scores in the observation group were lower than those in the control group (<0.05). The difference of NIHSS scores before and after treatment in the observation group was higher than that in the control group (<0.01). After treatment, the BI grading was better than that before treatment in the two groups (both <0.05), and the BI grading in the observation group was superior to that in the control group (<0.05).@*CONCLUSION@#On the basis of " acupuncture" combined with nifedipine controlled release tablets in the treatment of elderly patients with stroke complicated with hypertension, " acupuncture" can further improve the function of nerve and limbs, effectively reduce the morning blood pressure level of elderly patients, especially diastolic blood pressure, and significantly improve systolic blood pressure and diastolic blood pressure load.

Acupuncture combined with medication for morning blood pressure of essential hypertension / 中国针灸

<p><b>OBJECTIVE</b>Based on the western medication, to evaluate the advantages in the morning blood pressure treated with acupuncture at Fengchi (GB 20) and Neck-Jiaji (EX-B 2) combined with acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen in the patients with essential hypertension.</p><p><b>METHODS</b>A total of 90 patients of essential hypertension of the mild and moderate degrees were randomized into a medication group (30 cases, 3 dropping), No.1 acupuncture group (30 cases, 2 dropping) and No.2 acupuncture group (30 cases, 1 dropping). In the medication group, adalat was prescribed for oral administration, 30 mg at 7 am every day, continuously for 6 weeks. In the No.1 acupuncture group, on the basis of the treatment as the medication group, the acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen was applied and the acupoints were Renying (ST 9), Hegu (LI 4), Taichong (LR 3), Quchi (LI 11) and Zusanli (ST 36). In the No.2 acupuncture group, on the basis of the treatment as the No.1 acupuncture group, Fengchi (GB 20) and Neck-Jiaji (EX-B 2) were added in acupuncture. Acupuncture was given in the time zone from 8 am through 10 am every day, once a day, 5 times a week, totally for 6 weeks. Separately, before treatment and in 2, 4 and 6 weeks of treatment, the morning blood pressure, the control rate and the symptom score were observed in the patients of the three groups. The morning blood pressure was followed up in 3 and 6 months separately.</p><p><b>RESULTS</b>Compared with those before treatment, in 2, 4 and 6 weeks of treatment, the levels of blood pressure reduced in the patients of the three groups (<0.05, <0.01). After 2-week treatment, the differences were not significant in the morning blood pressure and its control rate in the patients of the three groups (all >0.05). In 4 and 6 weeks of treatment, the levels of the morning blood pressure in the No.2 acupuncture group were lower than those in the No.1 acupuncture group, and the results in the No.1 and No.2 acupuncture groups were all lower than those in the medication group (all <0.05). In the follow-up visit for 3 and 6 months separately, the differences were not significant in the morning blood pressure among the three groups (all >0.05). In 2, 4 and 6 weeks of treatment, the symptom scores reduced as compared with those before treatment in the three groups (all <0.05). The symptom scores in the No.1 and No.2 acupuncture groups were all lower than those in the medication group (all <0.05). The differences were not significant between the No.1 acupuncture group and the No.2 acupuncture group (all >0.05).</p><p><b>CONCLUSION</b>The comprehensive treatment of acupuncture at Fengchi (GB 20) and Neck-Jiaji (EX-B 2) combined with acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen achieve the effects of reducing the morning blood pressure in the patients with essential hypertension, relieving the symptoms of hypertension such as headache, vertigo and tinnitus and the effects are better than those of the acupuncture technique for activating blood circulation, eliminating wind and regulating the liver and spleen.</p>

Blood pressure variability and circadian rhythms in young and middle-aged people with H-type primary hypertension / 重庆医学

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.

The effect of depression on morning blood pressure surge in maintenance hemodialysis patients with hypertension / 中华行为医学与脑科学杂志

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.

Effect of long-term alcohol consumption on morning blood pressure surge and its association with left ventricular hypertrophy in male hypertension patients / 第二军医大学学报

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.

Evaluation of antihypertensive effects of domestic olmesartan tablets on morning blood pressure surge by ambulatory blood pressure monitoring in patients with mild to moderate essential hypertension / 中国药学杂志

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.

Study on the relationship between blood pressure variability and senile asymptomatic cerebrovascular damage / 中国医师进修杂志

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.

Relationship Between Blood Pressure Variability and Ambulatory Arterial Stiffness Index in Both Normal Subjects and Hypertensive Patients / 中国循环杂志

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.

Effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge / 实用医学杂志

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.

Clinical study of the relationship between the level of morning blood pressure surge and hs-CRP in coronary events among old patients / 中国医师杂志

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.

Relationship between Morning Blood Pressure Surge and Myocardial Ischemia / 中国康复理论与实践

@#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.

Influence of irbesartan on urine microalbuminuria in elderly patients with morning blood pressure surge hypertension / 中国综合临床

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.

Influence of morning blood pressure on carotid atherosclerosis in elderly patients with essential hypertension / 中国基层医药

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.

Effects of combined irbesartan/hydrochlorothiazide on morning blood pressure surge and left ventricular mass in essential hypertension / 中国医师进修杂志

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.

The relativity study of carotid atherosclerosis and morning blood pressure surge / 中国医师进修杂志

Objective To investigate the relativity between morning blood pressure surge (MBPS) and carotid atheresclerosis. Methods Noninvasive ambulatory blood pressure monitor (ABPM) was per-formed on 97 patients with the first and second stage of essential hypertension and according the ABPM re-suits, the patients were classified into MP+ group (31 cases) and MP-group (66 cases). In the meantime, the carotid intima-media thickness (IMT) and the carotid atheresclerotic plaque was examined by the color Doppler ultrasound. The relationship among MBPS, carotid atherosclerotic plaque and IMT was analyzed.Results The IMT of common carotid artery (CCA), carotid artery bifurcation (CAB)and internal carotid artery (ICA) in MP+ group was significantly higher than that in MP- group [ (1.02±0.36)mm vs (0.86±0.22) mm, (1.14±0.39 ) mm vs(0.96±0.26) mm, (0.94±0.30 )mm vs ( 0.82±0.18 mm ), P<0.05 ]. The ratio of carotid atherosclerotie plaque in MP+ group was significantly higher than that in MP- group (64.5% vs 42.4%,P<0.05). Conclusions The MBPS is related to carotid atheroselerotie plaque and the carotid IMT. The MBPS may accelerate the forming and developing of atherosclerosis.

The Association Between Morning Blood Pressure Surge and Target Organ Damage in Hypertensives / 中华高血压杂志

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