RISK FACTORS FOR MYOCARDIAL ISCHEMIA IN ESSENTIAL HYPERTENSION AND ITS RELATIONSHIP WITH CIRCADIAN RHYTHM

Fei Wang^{1, #}, Fan Ouyang^{2, #}, Jun Liao³, Wei Wang³, Airong Fu^{3, *} 

¹Department of Electrocardiographic Room, Huanggang Central Hospital, Huanggang, Hubei, 438000, PR China - ²Department of Operating Room, Wuhan No.1 Hospital, Wuhan, Hubei, 430000, PR China - ³Department of Cardiology, The first people’s hospital of Huzhou (the first affiliated hospital of Huzhou teacher’s college), Huzhou, 313000, PR China

Objective: To investigate the risk factors for myocardial ischemia in essential hypertension and its re-lationship with circadian rhythm.

Methods: The clinical data of 492 patients with essential hypertension admitted to our hospital from January 2017 to January 2021 were analyzed retrospectively. All patients were grouped according to circadian rhythm types. The general data, myocardial ischemia and heart rate variability (HRV)-related indicators were analyzed. Logistic regression model was used to evaluate independent risk factors for intermittent and persistent myocardial ischemia in essential hypertension.

Results: There were no significant differences among different circadian rhythm sub-groups in age, gender, systolic blood pressure, diastolic blood pressure, myocardial ischemia, standard deviation of the NN (R-R) sinus-initiated interbeat-intervals (SDNN) and the proportion of average R-R intervals that differed by more than 50ms in the total number of R-R intervals (PNN50) (P<0.05). There were significant differences among different cir-cadian rhythm subgroups in the level of root mean square of successive differences between adjacent NN intervals (RMSSD) (P<0.05). Multivariate analysis showed that female and increased diastolic blood pressure were independent risk factors for intermittent myocardial ischemia in essential hypertension (P<0.05). Multivariate analysis indicated that increased systolic blood pressure was an independent risk factor for persistent myocardial ischemia in essential hypertension (P<0.05).

Conclusion: Gender and blood pressure are closely related to the occurrence of myo-cardial ischemia in essential hypertension, and the circadian rhythm type of blood pressure is affected by heart rate variability.