A Clinical Research On The Ralationship Between Ambulatory Arterial Stiffness Index And The Eearly Renal Damage In H Type Hypertention Patients

Objective: The mobidity of hypertension in Chinese has increased significantly in the recent 50 years,and in China the hypertensive population along with hyperhomocysteinemia has accounted for 75% of total.The essential hypertension accompanied with hyperhomocysteinemia is named H type hypertension by Chinese scholars.Studies suggest that homocysteine is an independent risk factor of cardiovascular disease and early renal damage.In addition,the synergistic effect of hypertension and high homocysteine levels on atherosclerosis is also a risk of cardiovascular disease.In the present study,we evaluated the association between ambulatory arterial stiffness index and early renal damage in patients with H type hypertension.Methods: According to the hypertension diagnosis standards of Guidelines for Prevention and Treatment of Hypertension in China(2010 Revision),50 inpatients in our hospital with essential hypertension were random selected from June 2014 to October 2015,including 30 males and 20 females,aged 34-83 years old(the mean age is 62.32 + 12.56 years old).All patients were taken blood samples and 24-hour ambulatory BP monitoring(ABPM)were tested.According to the plasma homocysteine level,the patients with Hcy>10?mol/L were divided into H group whereas others were assigned to pure hypertension group.And the urinary albumin-creatinine ratio(mAlb/Cr)of two groups were calculated.The correlation between ambulatory arterial stiffness index and mAlb / Cr of two groups was explored.Results:1 Comparison of the two groups in general clinical data shows thatthere are no significant differences in age,gender,body mass index(BMI),Course of hypertension,total cholesterol,triglyceride,fasting blood-glucose,low density lipoprotein,high density lipoprotein,systolic blood pressure and diastolic blood pressure on admission(P >0.05).2 AASI of two groupsAmbulatory arterial stiffness index is markedly higher in patients of the H group than of the pure hypertension group,which is statistically significant(P <0.05).3 ACR of two groupsACR is significantly higher in patients of the H group than of the pure hypertension group,with statistical significance(P <0.05).4 Pearson correlation analysis shows that AASI and the logarithmic transformed ACR value is positive correlated(r=0.705,P <0.05).5 Multiple linear regression analysis shows that Course of hypertension,Hcy,low density lipoprotein,nocturnal pulse pressure and fasting blood-glucose is the influencing factor of AASI;Hcy,AASI,fasting blood-glucose is the influencing factor of ACR.Conclusion:1 AASI of the H group is increased than the pure hypertension group,which shows that there is a certain relationship between hyperhomocysteinemia and atherosclerosis and that hyperhomocysteinemia may accelerate the progression of atherosclerosis in hypertensive patients.Hyperhomocysteinemia is also an important factor in the target organ damage of primary hypertension.2 ACR is increased in the H group than in primary hypertension,which shows that hyperhomocysteinemia may accelerate the progression of renal damage.3 Pearson correlation analysis shows that AASI and logarithmic transformed ACR value is positive correlated.It indicates that H type hypertension may be an independent risk factor for early Renal damage.