Clinical investigation on fluctuations of blood pressure related to the formation of the carotid atherosclerotic plaque in 1461 older patients.

Objective: Blood pressure variability was also an independent determinant of the target-organ damage as well as the high blood pressure itself.The aim of this study was to investigate the relationship between carotid atherosclerotic plaque and fluctuations of blood pressure in elderly people.Methods: 1461 cases were enrolled in the study.All patients underwent ambulatory blood pressure monitoring and extracranial carotid ultrasound examination.Extracranial carotid artery plaque index(PI) was calculated,and patients were grouped as carotid plaque group and normal group(control group) according to the results of PI.The data of systolic blood pressure and diastolic blood pressure from ambulatory blood pressure were collected and compared between the two groups.Results: ①Fluctuations of systolic blood pressure were closely related with the formation of the carotid atherosclerotic plaque in the plaque group(8.3 ± 2.1 mmHg vs 7.9 ± 2.0 mmHg,P<0.001),especially in day time(6:00-22:00)(8.1 ±2.1 mmHg vs 7.7 ± 2.1 mmHg,P<0.001),but no difference were found in night time(22:00-6:00)(8.9 ±3.8 mmHg vs 8.6 ±3.7 mmHg,P>0.05).② And the formation of carotid atherosclerotic plaque was also related more significantly to the diastolic blood pressure variability in carotid plaque group(5.6 ±1.4 mmHg vs 5.4 ± 1.4 mmHg,P<0.05),especially in day time(6:00-22:00)(5.4 ±1.4 mmHg vs 5.2 ±1.4 mmHg,P < 0.05),but no difference was found in night time between the two groups(22:00-6:00)(6.2 ±2.7 mmHg vs5.9 ±2.5 mmHg,P>0.05).Conclusion: The formation of the carotid atherosclerotic plaques in older people is related significantly with the fluctuation of both systolic and diastolic blood pressure,mainly with the day time fluctuation.