| Background:Essentia1Hypertension is one of the common cardiovascular diseases, and itis the leading cause of death in cardiovascular disease. Hypertension is a kindof disease caused by genetic and environmental factors, which lead to cardiovascular system adjustment function disorder, causing proliferation of vascular smooth muscle, myocardial and extracellular matrix. Hypertension affects heart,brain, kidney structure and function seriously. Cardiovascular disease caused byhigh blood pressure is a gradual process. Inflammatory reaction and the reconstruction of extracellular matrix may play an important role in the early elevated blood pressure. Monocyte chemoattractant protein-1(MCP-1) have a strong role in chemotaxis of Monocyte/macrophages, which is the beginning factor of the inflammatory process. Ambulatory arterial stiffness index (AASI) was proposed in recent years to estimate arteriosclerosis according to24h ambulatory blood pressure. AASI can be used as the substitution index of arteriosclerosis. Research abroad in recent years consider that AASI independent related to all sorts of causes of death, better predict cardiovascular death than classical risk factors, prediction function independent of pulse pressure, can effectively evaluatecardiovascular risk. Whether MCP-1is related to AASI in prehypertentives andearly intervention would affect MCP-1expression has not been reported.Objective:1. To observe the difference of24h ambulatory blood pressure and AASI in normotensives, prehypertensives and hypertensives.2. To explore the difference of MCP-1in normotensives, prehypertensives andhypertensives participants.3. To investigate the relationship between MCP-1and AASI in prehypertensiveparticipants.4. To observe the effect of drug intervene on the expression of MCP-1inprehyertensive participants.This paper aims to study the relationship between MPC-1expression and AASIin prehypertention, and drug intervention on the expression of MPC-1, to supply theory basis on early prevent and clinical treatment of arteriosclerosis.Methods:According to the standard of Chinese Hypertension Prevention Guide (2009grassroots version), one hundred and twenty normotensives, prehypertensives andhypertensives were enrolled respectively, age and gender were matched in the threegroups. Secondary hypertension, diabetes, coronary heart disease, hyperlipidemia andinflammatory diseases were excluded. Biochemical parameters such as fasting plasmaglucose and lipids were measured; MCP-1was tested by ELISA;24h ambulatoryblood pressure monitoring (ABPM) was carried out in the three groups, respectively,AASI was computed; The prehypertensions were divided into high AASI group andlow AASI group based on different AASI; After1year drug intervene, basic clinicaldata of prehypertention such as age, height, weight, blood pressure and heart rate werere-collected; Biochemical parameters were re-measured,24h ambulatory bloodpressure monitoring were carried out again to computed AASI. MCP-1was retestedby ELISA.Results:1. The systolic pressure (SBP), diastolic pressure (DBP), pulse pressure (PP) andfasting blood-glucose (FBG) in prehypertensives (136.18±3.89mmHg,82.53±5.01mmHg,53.01±5.76mmHg,4.92±0.46mmol/L) are higher thannormotensives (116.37±4.59mmHg,74.80±2.76mmHg,40.87±3.61mmHg, 4.80±0.47mmol/L, P <0.05), while lower than hypertensives (148.99±5.86mmHg,87.40±4.65mmHg,61.41±7.72mmHg,5.11±0.71mmol/L, P <0.05).2. The expression of MCP-1in normotensives, prehypertensives and hypertensivesincrease successively, and have significant difference between each two groups,respectively (14.30±1.84,15.98±2.01,18.59±2.09, P <0.01).3. AASI in prehypertensives (0.42±0.13) were higher than in normotensives (0.36±0.15, P <0.01), while lower than(0.49±0.12, P <0.01).4. MCP-1in high AASI group were higher than low AASI group, the difference havestatistical significance (P <0.01).5. MCP-1in prehypertensives is positively correlated with age, body mass index,total cholesterol, triglyceride, low density lipoprotein cholesterol, fastingblood-glucose, the SBP and PP in24h, the SBP and PP in daytime, the SBP andPP in night (P﹤0.05), while it is negative correlated with high density lipoproteincholesterol (P﹤0.01).6. Multiple liner regression showed that: MCP-1=7.77+5.989×AASI+0.129×24hPP (mmHg), AASI and24hPP were risk factors for MCP-1.7. After drug intervene in prehypertensives, SBP, DBP, total cholesterol, triglyceride,low density lipoprotein cholesterol, fasting blood-glucose and MCP-1were lowerthan before (P <0.01), while high density lipoprotein was increased than before(P <0.01).8. After drug intervene in prehypertensives, all the data of24h ambulatory bloodpressure and AASI were decreased than before, the difference have statisticalsignificance (P <0.01).9. After treatment, the number of people in high AASI group was decreased, thenumber of people in low AASI group was significant increased.10. After treatment, Pearson correlation analysis showed that the level of MCP-1waspositively correlated with AASI in prehypertensives, multiple liner regressionshowed that AASI was risk factors for MCP-1.Conclusion: 1. All the data of24h ambulatory blood pressure and AASI in prehypertensivesincreased, arteriosclerotic was happened in early stage of high blood pressure.2. Compared with normotensives, the expression of MCP-1increased, and waspositively correlated with AASI, showed that inflammatory response washappened in prehypertensives, MCP-1was related with vascular remodeling inprehypertensives.3. After treatment in prehypertensives, AASI and MCP-1decreased along with bloodpressure, showed that small doses of drugs can lower blood pressure, slow downthe intervention arteriosclerosis, reduce blood vessel inflammation, provided abeneficial exploration of drug treatment for pyhypertensives.4. MCP-1in peripheral blood may become a new marker of early atherosclerosis inprehypertensives. |
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