PREDICTIVE EFFECT OF 24H SYSTOLIC AND DIASTOLIC BLOOD PRESSURE VARIABILITY ON CARDIOVASCULAR EVENTS IN ELDERLY HYPERTENSIVE PATIENTS

Shuhong Ma¹, Ying Li¹, Lisha Lin¹, Xiaoxia Zhang², Erning Wang^{3, *}

¹Department of Nursing, Weinan Vocational and Technical College, Weinan 714026, Shaanxi Province, China - ²The First Affiliated Hospital of Xi 'an Jiaotong University, Xi’an 710061, Shaanxi Province, China - ³Department of Emergency, Weinan Central Hospital, Weinan 714000, Shaanxi Province, China

Objective: To analyse the predictive effect of 24h systolic and diastolic blood pressure variability on cardiovascular events in elderly hypertensive patients.

Methods: A total of 239 elderly hypertensive patients admitted to our hospital from January 2019 to January 2020 were selected and divided into a mild group (SBP at 140–159 mmHg and/or DBP at 90–99 mmHg, n=107), a moderate group (SBP at 160–179 mmHg and/or DBP at 100–109 mmHg, n=72) and a severe group (SBP at 180 mmHg and/or DBP at 110 mmHg, n=60). After three months of follow-up, the physical indexes, diastolic blood pressure (DBP), systolic blood pressure (SBP), blood pressure variation characteristics, blood glucose and lipid metabolism indexes of the three groups of patients were compared; the incidence of cardiovascular and cerebrovascular events of the three groups of patients was compared; and the influencing factors of cardiovascular events in elderly patients with hypertension were analysed using multivariate logistic regression.

Results: The levels of 24hSBP, 24hDBP, dSBP, dDBP, nSBP, nDBP, 24hSBPCV and dSBPCV in the moderate and severe groups were significantly higher than those in the mild group, and the levels of nSBPCV in the moderate and severe groups were significantly lower than those in the mild group; the levels of 24hSBP, 24hDBP, dSBP, dDBP, nSBP, nDBP, 24hSBPCV and dSBPCV in the severe group were significantly higher than those in the moderate group, and the levels of nSBPCV in the severe group were significantly lower than those in the moderate group, with significant differences (P<0.05). The incidence of cerebral thrombosis, cerebral haemorrhage and myocardial infarction in the moderate and severe groups were significantly higher than that in the mild group, and the incidence of cerebral thrombosis, cerebral haemorrhage and myocardial infarction in the severe group was significantly higher than that in the moderate group; again the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that 24hSBP, 24hSBPCV and dSBPCV were the influencing factors of cardiovascular events in elderly hypertensive patients (P<0.05).

Conclusion: The 24h systolic and diastolic blood pressure variability index varies with blood pressure in elderly hypertensive patients. The higher the blood pressure, the higher the incidence of cardiovascular and cerebrovascular events. The influencing factors of cardiovascular events in elderly hypertensive patients are 24hSBP, 24hSBPCV and dSBPCV.