Relationship Between Ambulatory Pulse Pressure, Pulse Pressure Index and Coronary Artery Disease in Hypertension Patients / 中国循环杂志

ABSTRACT

Objective: To investigate the relationship between 24-hour ambulatory pulse pressure (24hPP), 24-hour ambulatory pulse pressure index (24hPPI), night-time ambulatory pulse pressure index (NPPI) and coronary artery disease (CAD) occurrence in hypertension patients. Methods: A total of 305 subjects received ambulatory blood pressure monitoring (ABPM) in our hospital from 2016-05 to 2016-07 were enrolled. Base on ABPM information, 24hPP, 24hPPI and NPPI were calculated to analyze their relationship to CAD occurrence. 24hPP was defined by 24-hour mean systolic blood pressure (24hSBP) minus 24hDBP, 24hPPI by the ratio of 24hPP/24hSBP and NPPI by the ratio of night (2200-600) PP/SBP. Results: There were 222/305 (72.8%) subjects with hypertension. Compared with normotension subjects, hypertension patients had increased 24hPP (49.0±11.6) mmHg vs (42.2±7.4) mmHg, P<0.001, 24hPPI (0.39±0.06) vs (0.37±0.05), P=0.004 and NPPI (0.40±0.07) vs. (0.38±0.06), P=0.009 respectively. 116/222 (52.3%) hypertension patients suffered from CAD. Compared with non-CAD patients, CAD patients presented elevated 24hPP (50.9±12.2) mmHg vs (47.0±10.6) mmHg, P=0.013, 24hPPI (0.41±0.07) vs. (0.38±0.06), P<0.001 and NPPI (0.42±0.07) vs. (0.38±0.06), P<0.001 respectively. Among 83/305 (27.2%) normotension subjects, the above indexes were similar between CAD patients and non-CAD subjects. Logistic regression analysis demonstrated that with adjusted age, gender, body mass index (BMI) and antihypertensive medication, 24hPPI [OR=1.95, 95% CI 1.11-3.44, P=0.020] and NPPI [OR=2.21, 95% CI 1.28-3.82, P<0.01] were related to CAD occurrence. ROC curve analysis showed that 24hPPI and NPPI were superior to 24hPP for CAD screening and prediction in hypertension patients. Conclusion: 24hPPI and NPPI were closely related to CAD occurrence in hypertension patients, they were both helpful for CAD screening and prediction in hypertension patients.