Comparison Of Plasma Angiotensin And Aldosterone Levels In Patients With Different Salt-sensitive Hypertensive Patients

Background:The majority of patients with essential hypertension in China are salt sensitive hypertension.In recent years,some studies have suggested that the blood pressure rhythm and 24 hour heart rate can be used for the risk stratification of patients with essential hypertension.Study showed that the serum aldosterone level was significantly higher in salt sensitive subjects,and high level of aldosterone is not only related to the level of blood pressure,but also related to the target organ damage of hypertension.In this study,we compare the difference of plasma angiotensin and aldosterone levels in patients with different salt sensitive hypertensive by a simple method of judging results by ambulatory blood pressure in salt sensitivity.Objectives:To compare the difference of plasma angiotensin and aldosterone levels in patients with different salt sensitive hypertensive patients.Methods:A total 382 primary hypertensive patients from the first affiliated hospital of Dalian Medical University between September 2015 and September 2016 were enrolled in this study.The gender,age,course of hypertension,blood pressure,smoking status,medication situation were recorded.The height,weight,Body Mass Index(BMI)were measured.Blood lipid,fasting blood glucose,blood lipid,creatinine,blood uric acid,sodium,potassium,angiotensin I,angiotensin II,aldosterone,ARR were evaluated.The 24 h ambulatory blood pressure monitoring were underwent to observe the average of 24 h ambulatory blood pressure,nocturnal average blood pressure and diurnal average blood pressure.Patients were devided into 3 classes of sodium sensitivity risk on the basis of ambulatory blood pressure data:low risk if dippers and a 24-hour heart rate?70bpm,high risk if nondippers and a 24-hour heart rate>70bpm and intermediate risk with the remaining combinations(dippers with heart rate >70bpm or nondippers with heart rate ?70bpm).According to the measurement data of normal distribution with means ± standard deviation,and comparison between the groups use variance analysis;does not meet the normal use of the median(four percentile),comparison between groups using Kruskal-Wallis rank sum test;multiple comparisons using SNK method;count data using frequency(%),comparison between groups use the chi square test;P<0.05 was considered statistically significant?Result:Compared with gender,BMI,course of hypertension,blood pressure,smoking status,medication situation,SBP blood lipid,fasting blood glucose,blood lipid,creatinine,blood uric acid,sodium,potassium were no statistic difference(P>0.05)?The age of high-risk group was lower than that of low risk group,the difference was statistically significant(P<0.05).The 24h-SBP,24h-DBP,N-SBP,N-DBP,D-DBP of high-risk group was higher than that of low risk group,the difference was statistically significant(P<0.05).The angiotensin I,angiotensin II of high-risk group was lower than that of low risk group,and the angiotensin I,angiotensin II,ARR of high-risk group was lower than that of low risk group,the difference was statistically significant(P<0.05).Conclusion: 1.The plasma levels of aldosterone were increased and the nocturnal blood pressure increased in the salt sensitive group,and both of them increased the damage of target organs.2 The angiotensin I,angiotensin II were low in salt sensitive hypertensive patients,suggesting that most of them were low renin hypertension.3 Inhibition of RAAS to decrease of aldosterone level in hypertensive patients with salt sensitivity is one of the key measures to control blood pressure and target organ damage in patients with salt sensitive hypertension.