Study On The Correlation Between Different Targets Of Different Blood Pressure Measurements And Early Renal Damage In Patients With Hypertension

Background and Objective: Hypertension is a high-prevalence cardiovascular syndrome in all world region,which will be a series of hypertension-mediated target organ damage(HMOD),including heart,brain,kidney and blood vessels,occur as the disease progresses.Blood pressure monitoring is the main method to evaluate blood pressure control,and standardized blood pressure monitoring can further predict HMOD.The main purpose of this study is to evaluate the correlation between different blood pressure targets of different blood pressure measurement and early renal damage in hypertensive patients as well as the sensitivity and specificity of early renal damage markers.Methods: This study was a prospective,randomized controlled trial.The diagnostic criteria of hypertension adopted the 2018 Chinese Hypertension Guidelines.Eighty patients who met the inclusion and exclusion criteria were randomly divided into two groups: office blood pressure(OBPM)target-reaching,and home blood pressure(HBPM)target-reaching.Systolic blood pressure(SBP)was adjusted to the randomized target range within one month(SBP < 140 mmHg in the OBPM target-reaching group;SBP < 135 mmHg in the HBPM target-reaching group).The patients were followed up by outpatient or telephone at one,two and three months,and then every three months until the end of the study.Antihypertensive drugs(olmesartan,amlodipine and diuretics)were timely titrated to achieve blood pressure targets.Ambulatory blood pressure monitoring(ABPM),24 h urinary microalbumin(24h Alb),urinary transferrin(TRF),urinary neutrophil gelatinase-associated apolipoprotein(NGAL),urinary renal injury factor and other test indicators were perfected after one-year follow-up.SPSS 22.0 software was used for all statistical analysis.Result: Compare with HBPM target-reaching group,24 h urinary microalbumin,serum creatinine,urinary microalbumin and TRF were significantly higher in OBPM target-reaching group(all P < 0.05).In the correlation analysis of early renal damage,24 h Alb was not significantly correlated with NGAL,only positively correlated with urinary microalbumin(Alb),but when we selected early renal dysfunction(24h Alb > 30 mg),24 h Alb was positively correlated with NGAL and urinary microalbumin(r = 0.22 and 0.291,respectively,P < 0.05).It was also still negatively correlated with TRF,and this result was consistent with the above results.Conclusion: Compare OBPM target-reaching group,patients with HBPM reached target have a closer relationship,and patients with HBPM reached have better renal protective function than patients with OBPM standard-reaching.In markers of kidney injury,24 h Alb still plays an irreplaceable role.When 24 h Alb was more than 30 mg,NGAL can also reflect early renal injury and is positively correlated with 24 h Alb.