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Visit-to-visit variability [VVV] in blood pressure [BP] creates challenges to hypertension control and was independent associated with increased all-cause mortality in hypertensive patients. The major goal of the present study was to investigate the association of VVV in systolic [S]BP with progression of carotid atherosclerosis and endothelial dysfunction in on-treated hypertensive patients. Overall, 356 hypertensive patients were enrolled and completed the trial. Clinic BP was measured at base-line and at 3 monthly thereafter. Carotid artery ultrasound and endothelial function were evaluated at baseline and annually follow-up visit. VVV in BP was assessed by standard deviation [SD] and coefficient of variation [CV] of serial follow-up BP measurements. The patients were divided into low, middle, and high group by tertile of SD in SBP. Decrease percentage of maximum intima-media thickness [IMT] and stiffness index beta and increase percent-age of brachial flow-mediated dilation [FMD] and nitric oxide [NO] in lower groups were significant greater than in higher groups [P < 0.05]. Change percentage of stiffness index beta and endothelin-1 positively, and change percentage of FMD and NO negatively correlated with SD, CV, maximum, and delta of SBP [P < 0.05]. SD and CV of SBP were risk factors for change percentage of IMT, stiffness index beta, FMD, NO, and endothelin-1 independently of other influential factors, such as age, and mean SBP. Excessive VVV in SBP maybe increase carotid atherosclerosis and impair endothelial function in on-treated hypertensive patients. Reducing VVV in SBP is benefit for patients with hypertension management
Assuntos
Humanos , Masculino , Feminino , Sístole , Doenças das Artérias Carótidas , Endotélio , Hipertensão , Gerenciamento ClínicoRESUMO
Objective To investigate the current condition of essential hypertension in the elderly aged over 60 yrs in rural and urban areas in Jinan. Methods 2 626 subjects aged over 60 years in rural and urban of Jinan were involved and were examined. The investigation was based on the unified questionnaire. The contents of questionnaire mainly included the history, treatment and control of hypertension. Results Prevalence of hypertension and rate of treatment in the male elderly in urban were 64.1% and 61.5% , respectively, and were higher than those in rural (56.9% and 38.3%, respectively). The treatment rate in female was higher in urban (60.8%) than in rural (43.1%) (P
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0.05) but a statistically significant negative correlation was noted between serum cholesterol and zinc (r= -0.9986, P