Peripheral Blood CD4~+T Cell Subsets And Dipper Hypertension,Non-dipper Hypertension Relationship Between Hypertension And Ambulatory Arterial Stiffness Index

Objective:By investigating the levels of Th1,Th2,Th17 and Treg cells and their associated cytokines in patients with essential hypertension,we further determined the relationship between the levels of Th,Th2,Th17 and Treg cells and the associated cytokines with dipper hypertension,non-dipper hypertension and ambulatory arterial stiffness index(AASI).CD4~+T cells and related cytokines in peripheral blood of patients with hypertension can provide a new clinical therapeutic perspective for immunotherapy of hypertension,provide therapeutic targets for future precise immunotherapy,control the damage of target organs and retain the necessary immunity.Methods:20 healthy people in the physical examination center of our hospital from 2018 to2020 were selected as the control group,and 80 patients with hypertension who met the diagnostic criteria of hypertension were admitted in the same period.According to the change trend of ambulatory blood pressure,the patients were divided into two groups:dipper hypertension and non-dipper hypertension.The gender,age,blood pressure related indicators(SBP,DBP,mean arterial pressure),urea,creatinine,uric acid,fasting blood glucose(FPG),blood lipid series(TG,TC,LDL-C,HDL-C),Th1,Th2,Th17,Treg,and related cytokines,Hcy,Cys,etc.Using 24-hour ambulatory blood pressure data,with systolic blood pressure as the independent variable and diastolic blood pressure as the dependent variable,a straight line can be drawn by using statistical software regression analysis,and the slope β of the straight line can be calculated.AASI is 1-β.Pearson correlation was used to analyze the relationship between the indicators.At the same time,multiple stepwise regression was used to predict the relationship between Th1,Th2,Th17,Treg and peripheral blood CD4~+T cell subsets(Th1,Th2,Th17,Treg)with Dipper hypertension group,non-dipper hypertension group patients and dynamic arteriosclerosis index as dependent variables.Results:1.Compared with the healthy control group,the age and AASI level of non-dipper hypertension group were higher,and the AASI level of dipper hypertension group was higher,the differences were statistically significant(P<0.05).Compared with dipper hypertension group,the age and AASI level of non-dipper hypertension group were higher,the differences were statistically significant(P<0.05).2.Compared with the healthy control group,the 24-hour systolic blood pressure average value and night systolic blood pressure average value in non-dipper hypertension group were higher,the 24-hour systolic blood pressure average value and day systolic blood pressure average value in dipper hypertension group were higher,the 24-hour systolic blood pressure average value,day systolic blood pressure average value and night systolic blood pressure average value in hypertension group were higher,the differences were statistically significant(P<0.05).Compared with dipper hypertension group,the night systolic blood pressure average value in non-dipper hypertension group was higher The difference was statistically significant(P<0.05).3.Compared with the control group,Th1/%,IL-17 and IFN-γ in non-dipper hypertension group were higher,Th2/%,Treg/%,IL-4 and IL-10 were lower.Th1 /%,IL-17 and IFN-γ in dipper hypertension group were higher,Th2/%,Treg/%,IL-4 and IL-10 were lower in the hypertension group,and Th1/%,IL-17 was higher in hypertension group,Th2/%,Treg/%,IL-4 and IL-10 were lower,and the difference was statistically significant(P<0.05).Compared with dipper hypertension group,the levels of IL-17 and IFN-γ in non-dipper hypertension group were higher,Th2/%,Treg/%,IL-4 and IL-10 were lower,and the difference was statistically significant(P<0.05).4.IFN-γ was positively correlated with Th1 in the hypertension group,dipper hypertension group,and non-dipper hypertension group,Th2 was positively correlated with IL-4,and Th17 was positively correlated with IL-17,and the differences were statistically significant(P<0.05).5.(1)In hypertension group,Th17/% was negatively correlated with 24 h systolic blood pressure,daytime systolic blood pressure,24 h diastolic blood pressure and daytime diastolic blood pressure.Treg/% was negatively correlated with nighttime systolic blood pressure and nighttime diastolic blood pressure.IFN-γ was positively correlated with nighttime systolic blood pressure and nighttime diastolic blood pressure(P<0.05).(2)In non-dipper hypertension group,Th1/% was positively correlated with 24 h systolic blood pressure and daytime systolic blood pressure.Th17/% was negatively correlated with daytime diastolic blood pressure.IFN-γ was positively correlated with24 h systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,nighttime diastolic blood pressure,24 h diastolic blood pressure and nighttime diastolic blood pressure(P<0.05).(3)In dipper hypertension group,Th17/% was negatively correlated with the mean value of 24-hour diastolic blood pressure and daytime diastolic blood pressure.IL-2 was negatively correlated with the mean value of 24-hour systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,24-hour diastolic blood pressure,daytime diastolic blood pressure and nighttime diastolic blood pressure.IL-6was negatively correlated with the mean value of daytime diastolic blood pressure.IL-17 was negatively correlated with the mean value of 24-hour diastolic blood pressure and daytime diastolic blood pressure The difference was statistically significant(P<0.05).6.The results showed that Th1/% was positively correlated with age,HDL and blood glucose,and negatively correlated with homocysteine.Th2/% was positively correlated with HDL,LDL and TC,and negatively correlated with age and Hcy.Th17/% was positively correlated with AASI,urea and creatinine.Treg/% was negatively correlated with age and AASI.IL-4 was negatively correlated with age,AASI and Hcy.IL-17 was positively correlated with age,AASI and Cys-C.The difference was statistically significant(P<0.05).7.With non-dipper hypertension as the outcome,binary logistic regression model was constructed.The results showed that Th1 and Th17 were the independent risk factors of non-dipper hypertension.Each unit of Th1 increased,the risk of non-dipper hypertension increased by 0.271 times.Each unit of Th17 increased,the risk of non-dipper hypertension increased by 3.08 times.Conclusion:1.The Th1 and Th17 levels of patients in non-dipper hypertension group were significantly higher than those of the healthy control group,but Th2 and Treg were lower than those of the healthy control group.At the same time,it was accompanied by higher levels of IFN-γ and IL-17 cytokines.On the contrary,the Th2 and IL-4 of non-dipper hypertension group were significantly lower than the healthy control group.In non-dipper hypertension patients,the dynamic arterial stiffness index(AASI)was close to 1,indicating high vascular stiffness.2.Peripheral blood CD4~+T cell subsets(Th1,Th2,Th17,Treg)and related cytokines are related to non-dipper hypertension,dipper hypertension and vascular stiffness.3.Th1 and Th17 are independent risk factors for non-dipper hypertension patients.