Study on early morning hypertension,cerebrovascular reserve function,and their correlation in 24 h ambulatory blood pressure monitoring in elderly population
Objective To investigate the correlation between early morning hypertension and cerebrovascular reserve function(CVR)in elderly population during 24 h ambulatory blood pressure monitoring.Methods A total of 300 elderly subjects who came to Jinan Maternal and Child Health Care Hospital for 24 h ambulatory blood pressure monitoring from January to December 2021 were retrospectively selected and were divided into group A,group B,and group C according to the monitoring results.There were 158 hypertensive patients with elevated blood pressure in the morning in group A,88 males and 70 females,aged(66.02±4.35)years.There were 74 hypertensive patients with normal blood pressure in the morning in group B,including 41 males and 33 females,aged(65.42±4.42)years.There were 68 patients with normal blood pressure in group C,including 37 males and 31 females,aged(65.77±4.38)years.With the mean of breath holding index of bilateral middle cerebral artery＜0.69％as reduced CVR,and the mean of breath holding index ≥0.69％as normal CVR,300 subjects were divided into a CVR reduced group(52 cases)and a CVR normal group(248 cases).The clinical data and CVR indexes among group A,B,and C were compared,the general data of the CVR reduced group and the CVR normal group were compared,and unifactor analysis,multi-factor analysis,and correlation analysis were performed.F test,independent sample t test,x2 test,logistic regression analysis,and Pearson correlation analysis were used.Results Among the 300 elderly subjects monitored for 24 h ambulatory blood pressure,there were 158(52.67％)hypertensive patients with elevated blood pressure in the morning,74(24.67％)hypertensive patients with normal blood pressure in the morning,and 68(22.67％)patients with normal blood pressure.The systolic blood pressure(24 h mean,daytime mean,and nighttime mean)and morning peak index of the 3 groups were as follow:group A＞group B＞group C(all P＜0.05).The diastolic blood pressure(24 h mean,daytime mean,and nighttime mean)of the 3 groups were as follow:group A＞group B and group C(all P＜0.05),there were no statistically significant differences between group B and group C(all P＞0.05).CVR:group A[(21.37±7.89)％]＜group B[(25.58±8.14)％]＜group C[(28.56±8.10)％](all P＜0.05).Breath holding index:group A[(0.89±0.2 3)％]＜group B[(1.13±0.21)％]and group C[(1.20±0.24)％](both P＜0.05);there was no statistically significant difference in the breath holding index between group B and group C(P＞0.05).Pulsation index:group A[(1.49±0.36)]＞group B[(1.15±0.31)]and group C[(1.06±0.29)](both P＜0.05);there was no statistically significant difference in the pulsation index between group B and group C(P＞0.05).In the CVR reduced group,the age[(73.14±3.21)years old],morning systolic blood pressure[(132.42±9.64)mmHg(1 mmHg=0.133 kPa)],and morning diastolic blood pressure[(68.85±6.59)mmHg]were higher than those in the CVR normal group[(64.28±4.36)years old,(121.58±7.26)mmHg,and(65.36±7.23)mmHg](all P＜0.05).Logistic regression analysis showed that age,morning systolic blood pressure,and morning diastolic blood pressure were all influencing factors for the decrease of CVR(all P＜0.05).The morning systolic blood pressure was negatively correlated with breath holding index(P＜0.05),and positively correlated with pulsation index(P＜0.05).The morning diastolic blood pressure was negatively correlated with breath holding index(P＜0.05),and positively correlated with pulsation index(P＜0.05).Conclusions In 24 h ambulatory blood pressure monitoring in elderly population,early morning hypertension patients had lower CVR and breath-holding index and higher pulsation index.Early morning systolic blood pressure and early morning diastolic blood pressure are negatively correlated with breath-holding index and positively correlated with pulsation index.
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