| Objective:The purpose of the study is to observe the level of rennin angiotensin aldosterone-system activity of Chinese patients with essential hypertension, and the relation between RAAS activity and target organ damage from hypertension。Also,we reveal the effect of RAAS-Test guide treatment.Methods:According to the inclusion criteria, we selected 504 cases who were admitted in our hospital accounted for essential hypertension from June,2012 to December,2014,including 186 male and 318 female.Clinical data were collected including age, gender, blood pressure levels, carotid artery plaque, left ventricular hypertrophy,cerebrovascular disease, renal damage, diabetes, LDL-C, uric acid, creatinine, PRA,Ang II, ALD. Skull CT was used to find out if the cerebral apoplexy happened, and Doppler was used to determine if carotid plaque and left ventricular hypertrophy existed.Logistic regression analysis was used to find out risk factors of targe organ damage including stroke, carotid artery plaque, left ventricular hypertrophy, and renal damage.During hospitalization,we adjusted the antihypertensive therapy according to different RAAS level:ACEI/ARB、aldosterone receptor antagonist would be prefered when the level of PRA、Ang II was high,and aldosterone receptor antagonist would be prefered when the level of ALD was high;and if the level of PRA、Ang II weren’t high,CCB and thiazide diuretics were preferred. At discharge time we analysed the blood pressure control and drugs selected, in order to evaluate the effect of RAAS-Test guide treatment.Results:1.In this study,504 patients with essential hypertension were included,aged 19~95(69.97 12.50) years, including 186 males and 318 females. 2.The proportion of high PRA, Ang II and ALD activity levels of the patients were 21.9%, 15.3%, 24.9%, and the total RAAS activity level was not high. 3. atients in high PRA group had shorterduration of hypertension(7.30±5.67 vs 9.31±8.05,P<0.05) and had more male(47.9%vs 34.2%,P<0.05). Patients in high ALD group were older than the control group(70.84±12.07 vs 67.07±13.46,P<0.01),and had higher levels of LDL-C(3.16±1.19 vs 2.88±1.06,P<0.05). 4. Correlation analysis showed that age was negatively related to PRA and ALD level, and LDL-C was positively related to PRA Ang II and ALD level. 5.Logistic analysis showed that PRA was an independent risk factor of LVH(OR=2.42,95%CI:1.32~4.42, P < 0.05), and was also an independent risk factor of cerebral vascular disease(OR=2.88, 95%CI:1.45~5.70, P < 0.05). 6.The usage of ACEI/ARB and aldosterone antagonists increased gradually, but usage of diuretic and CCB gradually reduced through RAAS level. The overall rate of blood pressure control was 93.7% in this study.Conclusion : 1.This study showed that RAAS activity was not high in most hypertension patient. 2.Ang age is negatively related to ALD level, and LDL-C was positively related to PRA、Ang II and ALD level. 3.High PRA level and hypertension level are independent risk factors of left ventricular hypertrophy,but Ang II and ALD have not obvious relevance with LVH. High PRA level 、 hypertension level and aged are independent risk factors of stroke,but Ang II and ALD have not obvious relevance with stroke. Sexual 、 hypertension duration and aged are independent risk factors of carotid plaque incidence,but PRA、Ang II and ALD have not obvious relevance with carotid plaque. High uric acid、hypertension duration and aged are independent risk factors of renal damage,but PRA、Ang II and ALD have not obvious relevance with renal damage.4.RAAS- activity-test-guide treatment can achieve advantage in blood pressure control. |
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