Effect of circadian rhythm of diastolic blood pressure on diastolic function in elderly hypertensive patients / 中国综合临床

ABSTRACT

Objective To analyze the effects of 24-hour diurnal blood pressure rhythm ( BPCR) changes on diastolic function in elderly hypertensive patients. Methods From February 2016 to February 2018,one hundred and twenty elderly patients with hypertension were divided into two groups according to their 24-hour ambulatory blood pressure status dipper group with 65 cases ( nocturnal blood pressure drop rate (＞10%) and non-dipper group with 55 cases ( nocturnal blood pressure drop rate＜10%); ambulatory blood pressure and echocardiographic relaxation were detected. Posterior wall (PW),interventricular septum (IVS),left ventricular diameter (LVEDD),left ventricular mass index (LVM) and left ventricular mass index (LVMI) were examined. Fractional shortening ( FS),stroke volume ( SV),cardiac output ( CO) and cardiac index (CI) were calculated,and peak flow time (A peak flow time total integration,ATVI) and peak flow velocity (A Pea) were measured. K flow rate ventricular (APFV); E peak flow time ventricular integral (ETVI ), early Peak flow Velocity ( EPFV ) and left ventricular ejection fraction ( LVEF ) were detected. Results The 24 h DBP, 24 hSBP, nocturnal DBP, and nocturnal SBP in dipper group were (80. 27±7. 29) mmHg,(125. 29±10. 38) mmHg,(69. 98±6. 36) mmHg,(110. 39±10. 52) mmHg,which were lower than those of the noninvasive group ((83. 82±7. 51) mmHg,(130. 89±10. 71) mmHg,(79. 81 ±6. 84) mmHg,( 126. 83 ± 10. 92) mmHg), the differences were statistically significant ( t ＝ 12. 809, 13.954,11.053,13.289,P＝0.042,0.021,0.014,0.006).The EPFV in the dipper group was (65.02 ±11. 83) cm/s,which was higher than that in the non-dipper group ((60. 84±11. 29) cm/s). The A/E, ATVI,and APFV in the dipper group were (1.03±0.58),(5.59±1.72) cm,(63.74±11.06) cm/s, respectively,lower than those in non-dipper group( (1. 14±0. 54),(6. 11±1. 68) cm,(68. 82±11. 17) cm/s),the differences were statistically significant (t＝10. 895,11. 643,12. 339,10. 854,P＝0. 032,0. 027, 0. 013,0. 006). Left ventricular diastolic function was negatively correlated with daytime DBP (r＝－ 0. 195,－0. 217,－0. 174,－0. 173,P＜0. 05) and positively correlated with nighttime SBP( r＝0. 194,0. 171,0. 220, 0. 206,P＜0. 05). Conclusion In elderly hypertensive patients,the left ventricular diastolic function and left ventricular hypertrophy are more serious in non-dipper patients, and it is necessary to strengthen the control of nocturnal blood pressure in elderly hypertensive patients.