Correlation Between Sleep Structure and Nighttime Blood Pressure Drop Rate in Hypertensive Patients and the Effect of Enhanced External Counterpulsation Intervention
WANG Xinyu
GUO Guangli
ZHAO Jiajia
FAN Junya
TIAN Xinyu
CHANG Xueli
ZHANG Hui
Abstract：Objective To explore the correlation between sleep structure and nighttime blood pressure drop rate in patients with hypertension,as well as the effect of enhanced external counterpulsation(EECP)intervention.Methods A total of 194 hypertensive patients who visited the Second Affiliated Hospital of Zhengzhou University from April to October 2024 were included in this study.According to the self rating sleep status scale(SRSS)score,they were divided into a sleep quality abnormality group(SRSS≤22 points)of 94 cases and a sleep quality normal group(SRSS＞22 points)of 100 cases,and the patients were all underwent sleep monitoring and dynamic blood pressure monitoring.The group with abnormal sleep quality was randomly divided into a control group of 47 cases and an intervention group of 47 cases.The control group was treated with antihypertensive drugs,while the intervention group was treated with antihypertensive drugs and EECP.After one course of treatment,sleep monitoring and dynamic blood pressure monitoring were performed again,and statistical analysis was conducted.Results Compared with the sleep quality abnormality group,the sleep quality abnormality group had higher daytime mean systolic blood pressure(dSBP),nighttime mean systolic blood pressure(nSBP),daytime mean diastolic blood pressure(dDBP),nighttime mean diastolic blood pressure(nDBP),and lower nighttime blood pressure drop rate.The proportion of patients in the deep sleep and rapid eye movement(REM)phases was lower,while the proportion in the light sleep phase was higher,and the difference was statistically significant(P＜0.05).With the decrease in total sleep duration,the proportion of deep sleep and REM phases,and the increase in the proportion of light sleep phases,the nighttime blood pressure drop rate in patients with abnormal sleep quality decreased,while dSBP and nSBP increased(P＜0.05).After treatment,both groups showed a decrease in dSBP,nSBP,dDBP and nDBP,an increase in total sleep duration and the proportion of deep sleep period,and a decrease in the proportion of light sleep period.Moreover,the improvement of these indicators in the intervention group was better than that in the control group(P＜0.05).Compared with before treatment,there was no significant improvement in the nighttime blood pressure drop rate in the control group,while the intervention group showed an increase(P＜0.05).Compared with before treatment,both groups showed a decrease in the proportion of awake phase and an increase in the proportion of REM phase,but the difference between the two groups was not statistically significant(P＞0.05).Conclusion This study found that as the proportion of deep sleep and REM phases decreases,dSBP,nSBP,dDBP,and nDBP all increase in hypertensive patients,and the nighttime blood pressure drop rate decreases.EECP can increase the total sleep duration and proportion of deep sleep in patients with abnormal sleep quality,lower blood pressure levels,and increase the nighttime blood pressure drop rate.
Keywords：hypertensionnighttime blood pressure drop ratesleep structureenhanced external counterpulsation
Publication Date：2025-05-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 1595-1600 )