Relationship of carotid atherosclerosis with ambulatory pulse pressure and ambulatory pulse pressure index and its risk factors in patients with essential hypertension

Objective To investigate the effect of ambulatory pulse pressure(APP)and ambulatory pulse pressure index on carotid intimamedia thickness in essential hypertension(EH) patients.Methods A total of 274 patients were enrolled in this study.All patients underwent ambulatory blood pressure monitoring(ABPM) and B-mode Doppler ultrasonography.The patients were divided into two groups:APP60 mmHg group(n=157)and APP≥60 mmHg group(n=117).The relationships between carotid IMT and APP or APPI were analyzed,and the risk factors of carotid atherosclerosis were analyzed in EH patients.Results Compared with APP60 mmHg group,IMT significantly increased in APP≥60 mmHg group [(0.61±0.35) cm vs(0.79±0.37)cm,P0.05].Between positive and negative carotid IMT patients,24 hSBP,24 hMAP and 24 hAPP were statistically different.Multiple logistic regression analysis showed that the 24 hAPP(OR=1.033,95%CI:1.018-1.048,P=0.000 1),male(OR=2.07,95%CI:1.183-3.613,P=0.011)and smoking(OR=1.808,95%CI:1.073-3.046,P=0.026) were three independent predictors of increased carotid IMT.Conclusion The higher the APP is,the worse the carotid atherosclerosis is.The 24 hAPP,and male and smoking are the three independent predictive factors of increased carotid IMT.