Effect Of Folic Acid Combined With ACEI On ACE Activity In Patients With H Type Hypertension And Analysis Of Other Correlative Factors

Objective(s):Select patients with H type hypertension as research object,to investigate the effect of folic acid combined with ACEI on ACE activity in patients with H type hypertension,then further discuss the expression of ACE mRNA and its related factors at the genetic level,to provide clinical basis for the treatment of H type hypertension.Methods:Select 110 patients with H type hypertension from the First People’s Hospital of Kunming from January 2016 to October 2016,According to the principle of randomization,group A and group B were divided into two groups,each group 55.A group was the study group,and B group was the control group.All information collected includes general data such as gender,age,body mass index(BMI),blood test data include fasting blood glucose(FBG),homocysteine(Hcy),folic acid,ACE activity,creatinine(CREA),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),other information includes systolic blood pressure(SBP),diastolic blood pressure(DBP).The liver and kidney function,adverse drug reactions and complications were monitored at the same time.Patients in group A were treated with perindopril 4mg and folic acid 0.8mg,while patients in group B were treated with perindopril 4mg,telephone communicated,telephone follow-up during the process of treatment,the patients who do not conform to the requirements were eliminated at any time in the course.After 3 months of regular treatment,the degree of blood pressure decrease,the change of Hcy and ACE activity levels,the control rate and effective rate of blood pressure were compared.And by extracting and amplificating of the total RNA of ACE,calculated the expression of ACE gene mRNA,to investigate the correlation between serum Hey,ACE activity and the expression of ACE gene.Results:After 3 months of treatment,patients who lost to follow-up and did not strictly follow the experimental design were excluded,a total of 103 patients remained,49 cases in group A,54 cases in group B,and the results were as follows.(1)The blood pressure,serum ACE activity and Hey levels were decreased than before,and the decreasing degree of group A was apparently higher than that of group B,all of the above differences were statistically significant(P<0.05).(2)The blood pressure control rate and total effective rate in group A were higher than those in group B,but the difference was not statistically significant(P<0.05).(3)Hey,ACE activity,ACE mRNA expression were positively correlated among each other in patients with H type hypertension.Conclusion(s):(1)Folic acid combined with ACEI can better reduce the blood pressure level in patients with H type hypertension,by decreasing the serum Hey level or by the further affect of Hyc level on ACE activity,but can not change the total effective rate.(2)In patients with H type hypertension,with the increase of serum Hey level,ACE activity and expression of ACE mRNA were enhanced,they had significant correlation among each other,so we can treat H type hypertension by reducing the level of Hey.