Prevention value of different blood pressure levels in H‐type hypertensive patients for stroke／ / 心血管康复医学杂志

ABSTRACT

To explore target blood pressure (BP) for lower incidence rate of stroke and better prognosis in patients with H‐type hypertension .Methods:A total of 600 patients with H‐type hypertension according to BP were divided into low level group (＜ 120／90mmHg or DBP ＜ 90mmHg , n ＝ 200 ) , medium level group (120 ～ 130／90mmHg or DBP＜90mmHg ,n＝ 200 ) and high level group (130～140／90mmHg or DBP＜ 90mmHg ,n＝ 200 ) , three groups were treated for two years .Levels of BP ,serum homocysteine (Hcy) ,carotid intima‐media thickness (CIMT) were measured and compared among three groups before and after treatment ,and incidence rates of ad‐verse events were recorded in three groups during follow‐up .Results:During follow‐up ,there were gradual signifi‐cant reductions in serum Hcy level and CIMT in three groups ,P＜0.05 or ＜0. 01. After four‐week follow‐up ,com‐pared with low level group ,there were significant rise in levels of BP and Hcy in medium and high level group ,and SBP of high level group was significantly higher than that of medium level group ,CIMT was significantly higher than the other two groups , P＝0.001 all ;after eight‐week and two‐year follow‐up ,compared with low level group , there were significant rise in levels of BP ,Hcy and CIMT in medium and high level group ,SBP and CIMT of high level group were significantly higher than those of medium level group ;and Hcy level of medium level group was sig‐nificantly higher than that of high level group after two‐year follow‐up , P＜0.05 or ＜0.01. After two‐year follow‐up ,recurrence rate of stroke ,incidence rates of cardiovascular diseases and adverse reactions in high level group were significantly higher than those of low and medium level group ,and recurrence rate of stroke in medium level group was significantly lower than that of low level group , P＜0.05 or ＜0.01. Conclusion:Total therapeutic effect of low level group is significantly better than those of medium and high level group .It can more significantly reduce Hcy level ,further reduce recurrence rate of stroke and mortality and more comprehensively control risk factors of cardiovascular diseases .