The Relationship Among Homocysteine、High-sensitivity C-reactive Protein、Blood Pressure Variability And Intima-media Thickness Of Carotid Artery In Patients With Essential Hypertension

Objective This study was designed to explore the relationship among the serum homocysteine(Hcy)、high-sensitivity C-reactive protein(hsCRP)、 blood pressure variability(BPV) and the intima-media thickness of carotid artery(cIMT) in patients with essential hypertensionMethods 215 patients with essential hypertension in the Cardiovascular Department of Anhui Provincial Hospital were enrolled in this study from January 2014 to December 2014, including 124 males and 91 females, aged from 27 to 86, with an average age of 62±11.215 patients are divided into three groups based on the results of carotid artery ultrasound examinations:IMT normal group, IMT thickness group and Plaque group. There are 69 patients in IMT normal group, including 37 men and 32 women, with an average age of 61±11; there are 74 patients in IMT thickness group, including 44 males and 30 females, with an average age of 61±11; and 72 patients in Plaque group, including 43 males and 29 females, with an average age of 65+10. All patients were conducted with general plasma biochemical examination: total cholesterol, blood triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and serum creatinine, as well as plasma Hey and hsCRP; and ambulatory blood pressure monitoring were used to obtain parameters which could reflect blood pressure variability:24hour systolic blood pressure standard deviation (24hSSD)..24hour diastolic blood pressure standard deviation (24hDSD)、 day systolic blood pressure standard deviation (dSSD)、night systolic blood pressure standard deviation (nSSD)、day diastolic blood pressure standard deviation (dDSD)、night diastolic blood pressure standard deviation(nDSD), all these indicators were analyzed statistically.Results Three groups showed no statistical differences (P> 0.05) in age, genders, blood total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), serum creatinine. Three groups showed statistical differences in hsCRP and Hey (P< 0.01) levels, compared with IMT normal group, the hsCRP and Hey levels were significantly increased in Plaque group and IMT thickness group. The hsCRP and Hey levels of Plaque group were higher than IMT thickness group. The comparison of 24hSSD, dSSD, nSSD among three groups had significant statistical differences (P< 0.01).The 24hSSD、dSSD、nSSD levels were significantly increased in Plaque group and IMT thickness group, while Plaque group’s were significantly higher than IMT thickness group. Linear correlation analysis showed that IMT was in positive correlation with hsCRP, Hey,24hSSD, dSSD, nSSD, nDSD, their r values were 0.643,0.732,0.407, 0.522,0.538 and 0.180 respectively (all P values< 0.01).Conclusion With the deterioration of carotid artery atherosclerosis, the hsCRP and Hey levels of patients with essential hypertension will increase significantly, and systolic blood pressure variability (24hSSD, dSSD, nSSD) also increases sharply. As for patients with essential hypertension, their cIMTs are in positive correlation with hsCRP, Hey,24hSSD, dSSD, nSSD and nDSD.