The Arterial Stiffness And Cardiovascular Risk Factors In Hypertension With Chronic Kidney Disease

Objectives To analyse the prevalence of chronic kidney disease(CKD)and the relevant risk factors of in-patients with hypertension from 2000 to 2007.Using the non-invasive arterial stiffness devices to evaluate early arterial damage in essential hypertension(EH) patients with CKD.Methods Retrospective study was performed based on the clinical characteristic and the relevant risk factors and target organ damage of EH with CKD.Prospective study was performed based on arterial stiffness of 202 subjects with EH.Results(1)Among 5889 hypertension inpatients,included 5168 subjects with EH,28.9%subjects with bath EH and CKD,10.9%and 22.0%of EH was characterized by GFR＜60ml/min·1.73m~2 and proteinuria,respectively,moreover,721 subjects among the whole patients were the secondary hypertension,the prevalence of proteinuria accounted 36%inpatients with primary aldosteronism.(2)The prevalence in subjects with GFR＜60ml/min·1.73m~2 were significantly decreased in the recent four years.(3)Compared with EH-non-CKD,the level of fasting plasma glucoseserum,uric acid,TG,HDL and the prevalence of diabetes and hyperuricemia were significantly higher in those with CKD,respectively, in addition,the risk rates of LVH and thicken carotid artery were also much higher.The prevalence CKD and proteinuria were markedly higher in those with male and old man(P＜0.05).(4)The risk factors of CKD was hyperuricemia,diabetes,hypertension risk stratification,PP,sex.(5) 202 subjects with EH,included 101 subjects with CKD,49 subjects with GFR＜60ml/min·1.73m~2,85 subjects with proteinuria.(6)Compared with EH-non-CKD,the level of hypertension,FPG and the prevalence diabetes and hyperlipidemia were significantly higher in those with CKD(P＜0.05).(7)Compared with EH-non-CKD,the level of AP,AIx,c-f PWV were significantly higher,C1,C2 were significantly lower in those with CKD.In 101 subjects of EH with CKD,Compared with CKD 1-2 stage, the level of AP,AIx,c-f PWV were significantly higher,C1,C2 were significant lower in those with CKD 3 stage.(P＜0.05).(8)GRF had the negtive correlation with CSBP,CPP,AP,AIx,c-fP WV,respectively,but for C2 was positive.The risk factors of CKD was hypertension risk stratification,fasting plasma glucose,AP and C1.Conclusions(1)There is high prevalence of CKD inpatients with secondary hypertension and high prevalence of proteinuria inpatients with PA.(2)The prevalence of subjects with GFR＜60ml/min·1.73m~2 is decreased.(3)The odd ratio of LVH and thicken carotid artery increase in EH patients with CKD.(4)There is high arterial stiffness(high level of blood pressure,AP,AIx,c-f PWV,and low level of C1,C2)inpatients with EH-CKD,The arterial stiffness is also increased with CKD 3 stage.