The Change And Relationship Of Radial Arterial Augmentation Index In Patients With Essential Hypertension And Diabetes

Background and purpose:Structure and function of vascular wall are abnormal existing in patients with hypertension and diabetes, and they will make arterial stiffness increase. The conclusion was drawn in latest domestic and international study that abnormal of vascular wall was the root cause of cardiovascular disease and acute cardiovascular cerebral-vascular events incidence. Arterial elasticity function is one of important ability of artery, which is not only the important determinant of systolic blood pressure and diastolic blood pressure but also to a large extent reflection of the artery endothelial function, flexibility dysfunction has become an important cardiovascular disease risk indicator. Radial augmentation index (AIR), which was measured by the technology applanationtonometry, has become one of the key indicators to evaluate the arterial elasticity. Now days, there are a lot of reach about the relevant between hypertension and AIR. To we all know that high blood sugar through many common ways to accelerate atherosclerosis, but reports about relationships between patients with hypertension and diabetes and AIR are absent. This study was designed to use the noninvasive technique to detect radial augmentation index, through which we can learn artery stiffness change situation in patients with hypertension and/or diabetes.Methods:73 patients (male:36;female:37;age:23~81 years old; average age 57.7±14.9 years old) with essential hypertension;59 patients (male:33;female:26;age:21~81 years old; average age 56.8±14.3 years old) with type 2 diabetes mellitus; 54 patients (male:27;female:27;age:23~83 years old; average 62.3±12.78 years old) combined with EH and T2DM(EH+T2DM) were enrolled. Secondary hypertension, coronary heart disease, arrhythmias, heart valve disease, heart failure, peripheral vascular disease, connective tissue disease, infection, liver and kidney dysfunction, other systems serious illness were excluded. And 72 healthy people as the normal control (matched with age, sex, smoking index, and body mass index) were chosen. All the objects never received antihypertension and the control of blood glucose treatment or stop the treatment over two weeks, and statin lipid-lowering drugs, aspirin and other antiplatelet aggregation drugs, nitrates drugs and so on were not taken. HEM-9000AI type (Japan Omron Corporation) pulse wave detection device was used to detect the radial augmentation index which heart rate correction is 75 times per minute that recorded as AIRP75.Results:There were no significant difference in age, sex, smoking index, body mass index, waist-hip ratio among the four groups (P>0.05). The level of cholesterol, triglyceride, low-density lipoprotein, serum creatinine in EH, T2DM and EH+T2DM groups were higher than those in control group (P<0.05).The systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) in EH, EH+T2DM groups were higher than the control group (P<0.05), no significant difference was found between EH and EH+T2DM groups (P>0.05). The fasting blood glucose both in patients with T2DM and T2DM+EH groups were higher than other two groups (P<0.01); the AIRP75 was higher in patients with EH and EH+T2DM groups than that in control group (P<0.05), but the significant difference was not found between other groups. Further factorial design for the analysis of variance conclusion: Hypertension and diabetes had not actual interaction; there had no statistics difference of AIRP75 in EH, T2DM and EH+T2DM groups. AIRP75 positively correlated with age (r=0.257, P<0.01),systolic blood pressure (r=0.222,P<0.01),pulse pressure( r=0.22,P<0.01)and smoking index(r=0.242,P<0.05);AIRP75 negatively correlated with height (r=0.381,P<0.01), body weight index (r=0.2,P<0.01); AIRP75 of hypertension group correlated positively with the hypertension history (r=0.251, P<0.05). Multilinear regression analysis indicated that AIRP75 correlated positively smoking index, waist-hip ratio, SBP, cholesterol, creatinine and correlated negatively with height, body mass index.Conclusion:The vessel wall structure and the arterial elasticity were impaired in patients with essential hypertension. The AIRP75 in patients with essential hypertension was increased. There was no difference between type 2 diabetes mellitus patients'AIRP75 and the control group's, so whether AIRP75 could be used as the indicator to evaluate artery elasticity needed to further explore.