血压昼夜节律与冠状动脉慢血流现象的临床相关性分析OA

Objective This study was aimed at investigating the clinical characteristics of diverse blood pressure circadian rhythms and exploring the correlation among blood pressure circadian rhythm,nocturnal blood pressure decline rate,and coronary slow flow phenomenon(CSFP).Methods A total of 275 patients who presented with chest tightness or chest pain and underwent coronary angiography(CAG)showing no significant stenosis(≤40%)at the Department of Cardiology,the Second Hospital of Lanzhou University from 2019 to 2024 were included in the study.The cohort was composed of hypertensive patients,CSFP patients,and patients with both conditions.According to the nocturnal blood pressure decline rate,all patients were classified into four groups:dipper,reverse-dipper,non-dipper,and extreme-dipper.General clinical data,CAG findings,and ambulatory blood pressure monitoring(ABPM)data were collected.Comparisons were carried out on the 24-hour,daytime,and nighttime mean blood pressure(BP),morning BP surge,and nocturnal BP decline rate.Linear correlation analysis and linear regression analysis were employed to investigate the correlation between CSFP and the nocturnal BP decline rate.Results Correlation analysis indicated that the corrected TIMI frame count(cTFC)was signifi-cantly and negatively correlated with the nocturnal systolic blood pressure(SBP)decline rate(r=-0.186,P<0.001)and the diastolic blood pressure(DBP)decline rate(r=-0.206,P<0.001).Multiple linear regression analysis verified that the nocturnal BP decline rate was an independent influencing factor for CSFP(P<0.05),and this correlation remained significant after adjusting for confounding factors such as gender,age,body mass index,smoking,diabetes,and cerebral infarction.Conclusions Both the decline rates of systolic and diastolic nocturnal blood pressure are independently correlated with the coronary slow flow phenomenon.Ambulatory blood pressure monitoring in hypertensive patients can assist in the detection of CSFP.