Study on the relationship between blood pressure variability and senile asymptomatic cerebrovascular damage

Objective To explore the relationship between asymptomatic lacunar cerebral infarction and blood pressure variability (BPV) in senile patients with essential hypertension.Methods According to the results of the cranial magnetic resonance imaging (MRI),160 patients were divided into two groups:96 cases of hypertension combined with lacunar cerebral infarction group and 64 cases of simple hypertension group.Their levels and variability blood pressure were investigated by 24 hours ambulatory blood pressure monitoring.All markers included 24 h average systolic blood pressure variation (24 h SBPV),24 h average diastolic blood pressure variation (24 h DBPV),the day average systolic blood pressure variation (dSBPV),the night average systolic blood pressure variation (nSBPV),the day average diastolic blood pressure variation (dDBPV),the night average diastolic blood pressure variation (nDBPV),the standard deviation (SD)and variable coefficient (CV) of morning peak systolic blood pressure and diastolic blood pressure.Results 24 h SBPV,dSBPV,nSBPV,24 h DBPV,dDBPV,nDBPV was increased significantly in hypertension combined with lacunar cerebral infarction group compared with those in simple hypertension group (0.15±0.03 vs.0.11 ± 0.02,0.14 ± 0.02 vs.0.10 ± 0.03,0.14 ± 0.03 vs.0.10 ± 0.08,0.13 ± 0.08 vs.0.11 ±0.04,0.14 ±0.02 vs.0.11 ±0.07,0.14 ±0.05 vs.0.09 ±0.02),and there was significant difference (P ＜ 0.05).SD and CV of morning peak systolic blood pressure and diastolic blood pressure in hypertension combined with lacunar cerebral infarction group was higher than that in simple hypertension group [(15.37 ±4.55) mmHg (1 mmHg =0.133 kPa) vs.(13.53 ±2.26) mmHg,(13.64 ±4.95) mmHg vs.(9.80 ± 3.46) mmHg,0.141 ± 0.048 vs.0.113 ± 0.037,0.145 ± 0.056 vs.0.105 ± 0.036],and there was significant difference(P ＜ 0.05).Conclusion The BPV,especially morning blood pressure surge BPV are increased significantly in the hypertension combined with lacunar cerebral infarction group compared with that simple hypertension group,BPV increase is one of the important risk factors of cerebral infarction. Key words: Blood pressure variability;  Morning blood pressure surge variability;  Cerebrovascular trauma;  Infarction, middle cerebral artery