Vascular Endothelial Function In Essential Hypertensives With Type 2 Diabetes Mellitus

Objective To evaluate the vascular endothelial function in essential hypertensives(EH)with type 2 diabetes mellitus(T2DM)by Endo-PAT2000 noninvasive vascular endothelial function detection system and analyze the related risk factors of reactive hyperemia index(RHI).Methods A total of 169 outpatients and inpatients with essential hypertension(including with and without antihypertensive treatment)from the First Affiliated Hospital of Fujian Medical University between October 2015 and December 2016 were enrolled,including 95 men and 74 women aged(56.4±9.9)years.Based on the hypertension and diabetes conditions,the patients were divided into two groups: EH with T2DM(EH+T2DM group,n=32)and without T2DM(single EH group,n=137).Meanwhile,69 subjects with normal blood pressure,normal fasting blood glucose and no drug administration were selected as controls(control group,n=69).All patients’ age,gender,case history,medication history and other basic information were recorded.Height,body weight and blood pressure were measured.Fasting blood glucose,blood lipid,hepatic and renal functions,glycosylated hemoglobin and homocysteine were measured in the morning.The reactive hyperemia index(RHI)detected by Endo-PAT 2000 noninvasive vascular endothelial function detection system was used to evaluate endothelial function.Subgroup analysis was performed based on the patients whether received antihypertensive therapy and statin therapy.Results1.Compared with control group,RHI in EH+T2DM group and single EH group were lower [(1.65±0.28),(1.76±0.23)vs(1.96±0.32),all P<0.05],while RHI in EH+T2DM group was significant lower than single EH group [(1.65±0.28)vs(1.76± 0.23),P<0.01].2.In single EH group,compared with without treatment group,RHI in single antihypertensive treatment group and antihypertensive combined statin treatment group were obviously higher [(1.74±0.15),(1.88±0.21)vs(1.53±0.27),all P<0.01],while RHI in antihypertensive combined statin treatment group was significant higher than single antihypertensive treatment group[(1.88±0.21)vs(1.74±0.15),P<0.01].3.In EH+T2DM group,compared with without statin treatment group,RHI in statin treatment group was obviously improved [(1.80±0.27)vs(1.45±0.13),P<0.01].4.Stepwise multiple linear regression analysis revealed that in all study subjects,age,systolic blood pressure,hypertension course,diabetes course and statin therapy were important related factors for RHI.RHI decreased by 0.1 as each 10 years-increasing of age.5.In EH,stepwise multiple linear regression analysis revealed that age and statin therapy were common related factors for RHI both in single EH group and EH+T2DM group.Hypertension course and antihypertensive treatment were related factors for RHI in single EH group.Diabetes course and HbA1 C were related factors for RHI in EH+T2DM group.Conclusions1.Age is an important related factor of vascular endothelial dysfunction.2.Vascular endothelial function was further decreased in essential hypertensives with type 2 diabetes mellitus compared with single essential hypertensives.3.Antihypertensive and statin treatment may improve the endothelial function.