Objective To investigate effects of morning blood pressure surge (MBPS) on cardiac remodeling and cardiovascular events in patients with essential hypertension.Methods Totally,386 patients with essential hypertension were recruited into the study,146 with MBPS and 240 without it based on their dynamic blood pressure monitoring.All the patients were monitored by 24-hour ambulatory blood pressure measurements,24-hour Holter electrocardiography and echocardiography for dynamic blood pressure,left ventricular mass index (LVMI),left atrial dimension (LAD),atrial and ventricular arrhythmias and ST depression,and so on.Results Compared with non-MBPS group,patients with MBPS had significantly higher incidence of left ventricular hypertrophy (LVH),enlargement of left atrial dimension,cardiac arrhythmias and myocardial ischemia detected,with LVMI [( 119 ±21 ) g/m2 vs.(93 ±12) g/m2,P＜0.01],LAD [(46±11) mmvs.(38±10) mm,P＜0.05],LVH (67.1% vs.30.4%,P ＜0.01 ),atrial premature beats (98.6% vs.84.2%,P ＜ 0.05 ),atrial tachycardia ( 54.1% vs.20.8%,P ＜ 0.01 ),atrial fibrillations ( 24.0% vs.0,P ＜ 0.0l ); ventricular premature beats and ventricular tachycardia ( 79.5% vs.57.9%,P ＜ 0.05,and 6.8% vs.2.5%,P ＜ 0.05 ),ST-segment depression (33.6% vs.13.8%,P ＜ 0.01 ),respectively.And,53.2 percent of cardiac arrhythmia and 57.6 percent of ST-segment depression occurred at six to eight o'clock in the morning.Blood pressure early in the morning and MBPS associated with ST-segment depression at the corresponding time ( P ＜ 0.05 ).Conclusions LVH is more significant,cardiac arrhythmias is severer and myocardial ischemia is more common in hypertensive patients with MBPS than that in those of non-MBPS.

Objective To investigate the expression levels and clinical significance of differentially expressed microRNAs(miRNAs)based on high-throughput sequencing in patients with left ventricular hypertrophy(LVH)and their possible regulatory mechanisms.Methods The miRNA sequencing was performed on plasma samples from 4 LVH patients and 4 healthy volunteers,and qRT-PCR validation was performed on plasma samples from 25 healthy volunteers and 35 LVH patients.The target genes of the obtained differentially expressed miRNA were predicted.The molecular function(MF),biological process(BP)and cellular components(CC)of these miRNAs were predicted by the Gene Ontology(GO)enrichment analysis,and their signal pathways were predicted by the Kyoto Encyclopedia of Genes and Genomes analysis.Meanwhile,the protein-protein interaction network was constructed.The diagnostic values of 2 differentially expressed miRNAs(hsa-miR-942-5p and hsa-miR-184)in LVH were analyzed by the area under the receiver operating characteristic(ROC)curve(AUCROC).Results A total of 945 differentially expressed miRNAs were identified,of which 1 and 9 were observed to be significantly upregulated and downregulated,respectively.The expression levels of hsa-miR-942-5p and hsa-miR-184 were verified by qRT-PCR to be significantly downregulated.The AUCROC of hsa-miR-942-5p and hsa-miR-184 were 0.694 6 and 0.880 4,respectively.Bioinformatics analysis revealed that the target genes were mainly enriched in the cell senescence,sphingolipid metabolism,and TGF-β,p53,and diabetic metabolism related signaling pathways.Conclusion The expression levels of hsa-miR-942-5p and hsa-miR-184 in plasma of LVH patients are significantly decreased,suggesting that they have good diagnostic potential.