Authors

Xiaoxia Lei

Departments

Department of Electrocardiogram, Zhangye People's Hospital Affiliated to Hexi College, Zhangye, PR China

Abstract

Objective: To explore the effectiveness of ambulatory blood pressure monitoring parameters, including morning blood pressure peak, night-time mean systolic pressure (nSBP), 24-hour mean systolic pressure (24h SBP), and night-time standard deviation of systolic pressure (nSSD) in assessing cardiovascular risk in patients with essential hypertension. 

Methods: 120 patients with essential hypertension who were treated in our hospital from March 2016 to May 2019 were divided into four groups according to the criteria of cardiovascular risk stratification: low-risk, medium-risk, high-risk and extremely high-risk. Among them, 21 were in the low-risk group, 30 were in the middle-risk group, 25 were in the high-risk group and 44 were in the extremely high-risk group. At the same time, 40 healthy people were selected to form the normal control group. The dynamic blood pressure parameters (morning blood pressure peak, nSBP, 24h SBP, and nSSD) of each group were observed, and the ROC curve was established to analyse the value of dynamic blood pressure monitoring parameters in assessing the cardiovascular risk of patients with essential hypertension. The Spearson correlation test was used to analyse the correlation between dynamic blood pressure parameters and cardiovascular risk. 

Results: Compared with the control group, the morning blood pressure peak, nSBP, 24-hour SBP and nSSD levels in the study group were significantly higher (P<0.05 or P<0.01). Compared with the low-risk group, the parameter levels in the middle-risk group, the high-risk group, and the extremely high-risk group increased significantly, and with the increase of cardiovascular risk, the parameter levels increased significantly (P<0.05 or P<0.01). The COX regression curve model was established and analysed. The results showed that the parameters were independent risk factors affecting cardiovascular disease in patients with essential hypertension. The ROC curve was established. The results showed that the areas under the curve (AUC) of morning peak blood pressure, nSBP, 24h SBP, and nSSD were 0.786, 0.826, 0.795 and 0.725, respectively. These parameters were valuable in assessing the cardiovascular risk of essential hypertension. The Spearson correlation analysis showed that the parameter levels were correlated with cardiovascular risk. The higher the level, the higher the cardiovascular risk of essential hypertension in patients. 

Conclusion: Morning blood pressure peak, nSBP, 24-hour SBP and nSSD levels in patients with hypertension are significantly higher than those in healthy subjects, and their levels are correlated with cardiovascular risk in patients with essential hypertension. The higher the level, the higher the risk of cardiovascular disease.

Keywords

Dynamic blood pressure monitoring parameters, morning blood pressure peak, nSBP, 24-hour SBP, nSSD, essential hypertension, cardiovascular risk.

DOI:

10.19193/0393-6384_2020_3_276