Clinical Study On The Relationship Between Serum Uric Acid And Blood Pressure Variability In Hypertensive Patients

ObjectiveTo investigate the relationship between serum uric acid level and blood pressure variability,carotid atherosclerosis in hypertension patients.MethodsWe collected 160 patients as the object of study,which admitted in our hospital(Fujian Medical University Affiliated Quanzhou First Hospital)during the period of June 2015 to December 2016,and clinically diagnosed as essential hypertension,of which 87 are males and 73 females with an average age of 63.41±10.33.All patients were taken neck arterial ultrasonography,24 h ambulatory blood pressure monitoring,and measured the biochemical indicators including serum lipids,fasting blood glucose,creatinine and serum uric acid.They were divided into uric acid normal group(SUA<420mmol/l,n=96)and uric acid increased group(SUA?420mmol/l,n=64)according to their serum uric acid level,compared the difference of two groups in the general information,laboratory test results and dynamic blood pressure parameters.In this study,the standard deviation of blood pressure readings was used as blood pressure variability indicators,the correlation between uric acid and blood pressure variability,carotid atherosclerosis was analyzed.Multiple linear regression was used to analyze the influencing factors of blood pressure variability.Multivariate logistic stepwise regression was used to analyze the risk factors of carotid atherosclerosis.Results 1.There were no significant differences in sex,age,smoking history,family history of hypertension,BMI,TG,TC,LDL-C,HDL-C,FBG and CRE in the two groups(P> 0.05).The serum uric acid level was significantly different between the two groups(348.95 ± 46.50,473.77 ± 45.37)(P <0.05).2.There were no significant differences between the two groups in 24 hDBP,dDBP and nDBP(P>0.05).But there were significant differences in 24 hSBP,24MPP,dSBP,nSBP,24 hSBPSD,24hDBPSD,dSBPSD,dDBPSD,nSBPSD and nDBPSD(P <0.05).3.The correlation analysis showed that uric acid was positively correlated with 24hSBPSD(r = 0.620),24hDBPSD(r = 0.254),dSBPSD(r = 0.646),dDBPSD(r = 0.212),nSBPSD(r = 0.606)and nDBPSD(r = 0.385)(P <0.05),which was weakly correlated with 24 hDBPSD and dDBPSD(r <0.3).4.Multiple linear regression analysis showed that uric acid is the influencing factor of 24hSBPSD(?= 0.438),24hDBPSD(?=0.299),dSBPSD(?=0.397),dDBPSD(?=0.249),nSBPSD(?=0.406),nDBPSD(?=0.407)(P <0.05).5.The detection rate of carotid atherosclerosis in the uric acid increased group was 89.1%,which was significantly higher than that in the uric acid normal group(P <0.05),the difference was statistically significant(P <0.05).6.The correlation analysis showed that carotid atherosclerosis was positively correlated with age,sex,smoking history,TC,LDL-C,UA,24 hSBP,dSBP,nSBP,24 hMPP,24hSBPSD,24 hDBPSD,dSBPSD,dDBPSD,nSBPSD,nDBPSD(P<0.05).Whether carotid atherosclerosis occurs as a dependent variable,UA,age,sex,smoking history,TC,LDL-C,24 hSBP,24hMPP,24 hSBPSD,24hDBPSD as independent variables,multivariate logistic stepwise regression analysis showed that UA,24 hSBP,24hSBPSD were chosen to enter the Logistic regression model,The OR values are respectively 4.252,1.263,1.796(P<0.05).ConclusionUA is the influencing factor of BPV in hypertensive patients.24 hSBP,24hSBPSD and HUA are all the independent risk factors of carotid atherosclerosis in hypertensive patients.