Objective To explore the ambulatory blood pressure features of the hypertensive convalescents with relatively well-controlled blood pressure, and to analyze the current status and independent risk factors of impaired blood pressure regulation function, so as to provide evidence-based support for precise rehabilitation and health management of hypertension in this population. Methods A total of 91 patients with primary hypertension and relatively well-controlled blood pressure were recruited from a convalescent center. All subjects underwent 24-hour ambulatory blood pressure monitoring (ABPM), and general clinical data and multi-dimensional ABPM indicators were collected. Impaired blood pressure regulation function was determined by non-dipping/reverse-dipping circadian rhythm, elevated nocturnal systolic blood pressure load, and increased blood pressure variability. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors. Results Among the 91 study subjects, 72 cases were identified with impaired blood pressure regulation function, with a prevalence rate of 79.12%. Specifically, dipping(18 cases), non-dipping(56 cases) and reverse-dipping(17 cases) rhythms accounted for 19.78%, 61.54% and 18.68% respectively, with a mean nocturnal systolic blood pressure decline rate of (3.44±6.31)%. The impaired group had significantly higher proportions of elevated nocturnal systolic blood pressure, increased nocturnal systolic blood pressure load, age≥60 years, and abnormal blood pressure circadian rhythm compared with the normal group (P<0.05). Multivariate Logistic regression analysis confirmed that elevated nocturnal systolic blood pressure load (OR=1.132, P=0.010), increased 24-hour systolic blood pressure coefficient (OR=3.008, P=0.020), and abnormal blood pressure circadian rhythm (OR=18 353.043, P=0.010) at baseline were independent risk factors for impaired blood pressure regulation function. Conclusions Multi-dimensional ABPM indicators can serve as a core means to evaluate the quality of blood pressure control and identify high-risk populations. Hypertension management should shift from“numerical compliance”to“function, rhythm, and quality compliance”.
Key words
ambulatory blood pressure monitoring /
convalescence /
hypertension /
blood pressure regulation function /
circadian rhythm /
precision management
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