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Objective To investigate the relationship between early progression in elderly patients with minor stroke and abnormal circadian rhythm of blood pressure.Methods From June 2013 to December 2016,180 patients with mild stroke (age >65 years,the National Institutes of Health Stroke Scale Score ≤3) at the Department of Neurology,Beijing Zhongguancun Hospital were recruited retrospectively.They were divided into either a progress group (n=48;the National Institute of Health Stroke Scale score increased≥2) or a non-progress group (n=132) according to whether they developed an early neurological deterioration (within 5 days after onset).The baseline data,risk factors for cerebrovascular disease (hypertension,diabetes mellitus,stroke,chronic smoking,alcohol consumption,hyperlipidemia,and homocysteine) in patients of both groups were compared.The normal (dipper-type blood pressure)/abnormal circadian rhythm of blood pressure (non-dipper-type blood pressure,super dipper-type blood pressure,and inverse dipper-type blood pressure) were monitored by ambulatory blood pressure monitoring.The guilty arteries were divided into severe stenosis or occlusion,non-severe stenosis or without stenosis.Multivariate logistic regression analysis and multi-class dummy variable analysis were further performed.Results The proportions of past diabetes history,stroke history,abnormal circadian rhythm of blood pressure,severe stenosis and occlusion of guilty artery in the patients of the progress group were higher than those of the non-progress group (70.8% [n=34] vs.49.2% [n=65],64.6% [n=31] vs.47.7% [n=63],89.6% [n=43] vs.26.5% [n=35],and 77.1% [n=37] vs.39.4% [n=52] respectively).The differences were statistically significant (all P<0.05).The factors of having statistical differences were substituted into multivariate logistic regression analysis,which showed that abnormal circadian rhythm of blood pressure (OR,7.072,95%CI 3.004-16.431;P<0.01) and severe stenosis or occlusion of guilty arteries (OR,6.217,95%CI 2.034-14.212,P=0.003) were the independent risk factors for early progression of minor stroke in the elderly.The dummy variable analysis of abnormal circadian rhythm of blood pressure showed that the super dipper-type blood pressure (OR,13.429,95%CI 4.175-111.668;P<0.01) in abnormal circadian rhythm of blood pressure was an independent risk factor for early progression of minor stroke in the elderly.Conclusion The abnormal circadian rhythm of blood pressure,especially super dipper-type blood pressure,may be the independent risk factor for early progression of minor stroke in the elderly,which needs to pay close attention to early intervention.
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Objective To explore the correlation between left ventricular hypertrophy (LVH) and dynamic parameters of blood pressure as well as blood pressure variation in patients with essential hypertension (EH). Methods From January to September, 2013, 581 patients with EH were divided into hypertrophy group (n=161) and non-hypertrophy group (n=420) according to the left ventricular mass index (LV-MI). The clinical data, biochemical indexes and dynamic parameters of blood pressure were compared, and the multiple factors regression was used to analyze the risk factors of LVH. Results The incidence of LVH was higher in women than in men (χ2=4.836, P=0.03), the level of blood uric acid was higher in the hypertrophy group than in the non-hypertrophy group (t=-11.540, P2.770, P<0.05). Multi-factor Lo-gistic regression analysis showed that gender (OR=1.674, P=0.044) and 24-hour systolic blood pressure load (OR=1.021, P=0.003) associat-ed with LVH. Conclusion The occurrence of LVH in patients with EH was closely related to the 24-hour systolic blood pressure load, and was higher in women than in men.
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Objective To study the relation between elderly hypertensive patients with accompanying type 2 diabetes mellitus and characteristics of ambulatory blood pressure. Methods 46 elderly hypertinsive patients with accompanying type 2 diabetes mellitus (experimental group) and 46 patients with essential hypertension (control group) through 24 hours use MEIGAOYI ambulatory blood pressure monitor. Results Comparison finds elderly hypertinsive patients with accompanying type 2 diabetes mellitus have lost normal blood pressure day and night rhythm, especially in aspect of obvious increasing of systolic pressure load and night systolic pressure. The results showed statistically significance (P<0.01,P<0.05). Conclusion For such elderly hypertinsive patients with accompanying type 2 diabetes mellitus treatment on high blood pressure should not only lower down too high blood pressure, but also lower down blood pressure steadily throughout 24 hours in the day and resume day & night rhythm.
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Objective To elucidate the clinical value of dynamic blood pressure monitor in the diagnosis and treatment of hypertensive heart diseases. Methods Twelve misdiagnosed patients with congestive heart failure were enrolled, including 7 male and 5 female, aging 67 to 78 years old. The hospitalization time, frequency and the therapeutic efficiency were compared before and after the diagnosis with the aid of dynamic blood pressure monitor. Results With the aid of dynamic blood pressure monitor, the patients with congestive heart failure were easily diagnosed. Following the proper control of high blood pressure, the heart failure improved swiftly. The hospitalization time was shorter and the hospitalization frequency was reduced as compared with that before proper diagnosis. Conclusion Dynamic blood pressure monitor is conducive to the diagnosis and treatment of congestive heart failure.
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Objective Studying the related factors of left ventricular hypertrophy for hypertensive disease, to provide the basis for clinical treatment. HZ Methods 500 hypertensive disease patients were performed dynamic monitoring of blood pressure and UCG. Then 130 patients with left ventricular hypertrophy were compared the dynamic blood pressure, age, sex and diseases course with 130 patients who had not left ventricular hypertrophy. Results (1) Systolic pressure, the load and the night descent rate of systolic pressure were significantly related to left ventricular hypertrophy, there was obviously difference in two groups. To the patients with systolic pressure and diastolic pressure were all increased, the incidence rate of left ventricular hypertrophy was reduced. (2) The age of left ventricular hypertrophy group was higher than no left ventricular hypertrophy group. (3) The female's incidence rate of hypertensive disease in left ventricular hypertrophy group was higher than no left ventricular hypertrophy group. (4) The course of diseases in left ventricular hypertrophy group was extended than no left ventricular hypertrophy group. The incidence rate of left ventricular hypertrophy was obviously higher in the patients whose blood pressure was increased in the daytime. Conclusion (1) The pulse pressure is a important forecast factor in numerous risk factor. (2) The advanced age is a risk factor to hypertensive disease. (3) The female hypertensive disease patients take place left ventricular hypertrophy is easier than the male. (4) Left ventricular hypertrophy is significantly related to hypertensive disease course, and isn't significantly related to blood pressure's durative. The clinic must think highly of observing and evaluating the pulse pressure, the long disease course of old female patients. There is important clinical significance to reinforce monitoring the risk factor of left ventricular hypertrophy, and to perform pertinent treatment and prevention for the high risk patients.