Clinical-Epidemiology Study On The Relationship Among Serium Electrolyte And Antihypertensive Efficacy Response To Irbesartan Treatment And Baseline Blood Pressure

Objective 1. To explore the relationship between serum electrolyte and the antihypertensive efficacy response to Irbesartan treatment in essential hypertension patients. 2. To assess the relationship between the concentration of the serum electrolyte and the baseline blood pressure. Methods 1. In order to elucidate the genetic and environmental influence on individualized response to antihypertensive, from December 2002 to January 2004, a study on pharmacogenomics in essential hypertension was conducted in a certain County , Anhui, China. The study is part of it. After community screening, 909 subjects(400 men, 509 women) were recruited to the prospective study cohort and 828 (367 men, 461 women) of them completed 28 days Irbesartan treatment, the collection of the baseline serum electrolyte concentration, clinical and epidemiological data were completed at the first day of the treatment. We analyzed the data with the methods of residual-residual, multiple linear regression and Logistic regression. 2. In order to explore various genetic and environmental factors' influence on osteoporosis, from October 2003 to April 2004, A genetic epidemiologic study on osteoporosis was conducted. In total, 2,273 subjects (995 men and 1278 women) were recruited to the study cohort through community screening. The data of serum electrolyte concerntration, systolic blood pressure (SeBP) and diastolic blood pressure (DeBP) were performed at baseline and the collection of clinical and epidemiological information were completed during the first day of the study. We analyzed the data by means of residual-residual, interactions among serum electrolyte and various confounding factors, Gee model analysis with SAS8.2 and S-plus2000 software. Results 1. There were linear relationship between the serum natrium, kalium, Na+/K+ ratio and the Irbesartan's acute or chronic therapeutic effect. The linear tendency among male EH patients are more significant than female ones. (1) As much as acute therapeutic effect, in total sample, 1 mmol/L increase of serum natrium and kalium concentration was found associated with -0.674mmHg (SE: 0.230) , -0.360mmHg (SE: 0.121) ,3.538mmHg (SE: 1.266) and 1.834mmHg( SE: 0.670)falls of SBP and DBP, while the decrease of SBP and DBP was -17.307mmHg (SE: 5.390) and -9.823mmHg (SE: 2.845) associated with Na+/K+ ratio increase 1 unit. In male EH patients, the acute antihypertensive efficacyofSBPandDBPwere-0.529mmHg (SE: 0.329) and -0.403mmHg (SE: 0.180) , 3.345mmHg (SE: 1.858) and 1.868mmHg (SE: 1.013) ,-16.179mmHg (SE: 8.084) and-10.454mmHg (SE: 4.396) with 1 mmol/L increase of serum natrium, kalium and 1 unit increase of Na+/K+ ratio; while in female EH patients, the acute SBP and DBP falls were -0.820mmHg (SE: 0.324) and -0.325mmHg (SE: 0.166), 3.398mmHg (SE: 1.738) and 1.165mmHg (SE: 0.898) , -17.149mmHg (SE: 7.263) and -8.647mmHg (SE: 3.742) . In chronic therapeutic effect, without delamination, 1 mmol/L increase of serum natrium concentration was associated with -0.500mmHg (SE: 0.228) and-0.413mmHg (SE: 0.133) in chronic falls of SBP and DBP, 1 mmol/L addition of serum kalium was associated with 2.392mmHg (SE: 0.748) decrease in chronic DBP curative effect, while the falls of DPB was -12.440mmHg (SE: 3.175 ) with 1 unit addition of Na+/K+ ratio. In male patients, 1 mmol/L increase of serum natrium, kalium and 1 unit addition of Na+/K+ ratio, then decrease of DBP were-0.569mmHg (SE: 0.200) , 2.182mmHg (SE: 1.148) and -12.116mmHg (SE: 4.946) , while in female EH patients, with the Immol/L addition of serum kalium and 1 unit increase of Na+/K+ ratio, the falls of DBP were 2.474mmHg(SE: 0.991) and-12.383mmHg(SE: 4.157). (2), there were significant difference in serum electrolyte between efficacy and inefficacy groups. Either in efficacy or inefficacy groups, acute or chronic therapeutic effect, devided or not, serum natrium concentration had significant difference in SBP and DBP falls. Serum kalium and Na+/K+ ratio also showed different levels diversity, some of them achieved statistical significance. The influen...