Ambulatory pulse pressure related indexes and serum high sensitive C-reactive protein in relation with carotid atherosclerosis in hypertensive patients

Objective: To study the effects of ambulatory pulse pressure related indexes, derived from ambulatory blood pressure monitoring, and serum high sensitive C-reactive protein (hsCRP) on carotid atherosclerosis in elderly patients with essential hypertension. Methods: A total of 126 elderly patients with essential hypertension underwent 24-hour ambulatory blood pressure monitoring (ABPM) and carotid color Doppler ultra-sonography. According to carotid intima-media thickness (IMT), the patients were divided into the normal IMT group (n = 33), the thickened IMT group (n = 49) and the plaque formation group (n = 44). Ambulatory blood pressure parameters (24 hPP, PPI and AASI) were calculated. The level of serum hsCRP in patients of the three groups was measured by immunoturbidimetry. The relationship of ambulatory pulse pressure related indexes (24 hPP, PPI and AASI) with serum hsCRP and carotid IMT was analyzed. Results: (1) In the thickened IMT group and the plaque formation group, 24 h systolic blood pressure (SBP), 24 hPP, PPI, AASI as well as levels of serum hsCRP, TC and LDL-C were higher than those in the IMT normal group, whereas FfDL-C was lower (P<0.05). Level of serum hsCRP was significantly elevated with the increase of carotid IMT (P<0.01). The difference between the thickened IMT group and the plaque formation group was also significant (P<0.05). (2) Pearson correlation analysis showed that carotid IMT was positively correlated with 24 hPP, PPI, AASI as well as serum hsCRP, TC and LDL-C, but negatively correlated with HDL-C (P<0.05). Conclusion: Ambulatory pulse pressure related indexes are good indicators for evaluating carotid atherosclerosis in elderly patients with essential hypertensim, and PPI and AASI have a greater value. Serum hsCRP may be an important cytokine affecting the process of AS. The level of serum hsCRP is closely related to ambulatory pulse pressure related indexes, and the two play an important role in the initiation and development of AS.