The Relationship Between Essential Hypertension With Target Organ Damage And Plasma Adrenomeduelin Levels

Objective:To study the level of adrenomedullin (ADM) in essential hypertension with target organ damage and its clinical significance.Method:202 hypertensive patients from the first affiliated hospital of Fujian medical university were divided into two groups: 131 hypertensive patients with target organ damage and 71 hypertensive patients without target organ damage according to the reference of target organ damage from Chinese Hypertension Prevention Guide(2005 edition). 100 healthy individuals from health examination served as control and were divided into two groups: the normal hypertensives group, the pre-hypertensives group. Adrenomedullin was detected using ELISA.Result:Hypertensives with target organ damage group had a significantly higher level adrenomedullin compared with other groups [(63.89±14.1)> (45.07±7.53) > (27.68±5.66) > (19.85±3.22) P < 0.01]; Bivariate Correlations analysis showed that adrenomedullin was negatively correlated with glomerular filtration rate (GFR), but positively correlated with type B natriuretic peptide (BNP), high-sensitivity C-relative protein (hs-CRP), serum creatinine (Cr), uric acid (UA), urine microalbumin (U-mAlb), Urinary Albumin to Creatinine Ratio(ACR), left ventricular ejection fraction (LVEF), lnterventricular septal thickness (IVST) significantly (r = -0.677, P < 0.01; r = 0.641, P < 0.01; r = 0.891, P < 0.01; r = 0.537, P < 0.01; r= 0.39, P < 0.01; r = 0.268, P < 0.01; r = 0.704, P < 0.01; r = -0.217, P < 0.01; r = 0.195, P < 0.05); Multivariate logistic regression analysis showed that adrenomedullin was significantly associated with hypertension with target organ damage and high-sensitivity C-relative protein (hs-CRP) (OR1.229 95%CI 1.149~1.315 P < 0.01 ),(OR 7.226 95% CI 5.701~9.158 P < 0.01).Conclusion:Adrenomedullin was positively correlated with worsening of hypertension with target organ damage and may be served as one of biomarkers of the worsening of essential hypertension. Objective:To observe the changes of adrenomedullin (ADM) in essential hypertensives with antihypertensive therapy and its clinical significance.Method:68 individuals from the first affiliated hospital of Fujian medical university were the hypertensives group。50 individuals from health examination were the normal group. Adrenomedullin was detected using ELISA. Adrenomedullin in the hypertensives group with received therapy for two weeks were detected again.Result:The hypertensives group had a significantly higher adrenomedullin compared with the normal group[(45.79±6.8)>(19.85±3.22), P < 0.01]. Adrenomedullin, systolic blood pressure and diastolic blood pressure in the hypertensives group without antihypertensive therapy were detected (45.79±6.84); (150.89±14.53) ; (83.07±12.10). Adrenomedullin, systolic blood pressure and diastolic blood pressure in the hypertensives group with antihypertensive therapy were detected (32.44±6.68);(124.11±10.67) ;( 72.01±6.91). Paired T test showed that the hypertensives group with antihypertensive therapy had a significantly lower adrenomedullin and blood pressure compared with before (P < 0.01). Bivariate Correlations analysis showed that adrenomedullin difference correlated with systolic blood pressure difference, diastolic blood pressure difference and mean arterial pressure difference significantly (r = 0.841, P < 0.01; r = 0.371, P < 0.01; r = 0.783, P < 0.01).Conclusion:Adrenomedullin was positively correlated with Blood pressure. After antihypertensive therapy,the serum levels of adrenomedullin significantly with the decrease in blood pressure showed a downward trend.