Relationship Between Renal Resistive Index And Primary Hypertension And Coronary Heart Disease

Objective: To detect the renal resistive index(RRI)of patients with essential hypertension and coronary heart disease by renal Doppler ultrasonography.Then compare values of RRI between the two groups,determine the correlation between RRI and hypertension and coronary heart disease and,find out the factors that influence RRI and discuss the mechanism.Method: 154 patients with essential hypertension were collected in this study,who were examined renal artery Doppler ultrasonography.118 subjects had only essential hypertension(HP),while other 36 patients had essential hypertension and coronary heart disease(HP+CHD).According this they were divided in two groups:HP and HP+CHD.Cardiac ultrasound and renal artery ultrasonography were performed on each subject and interventricular septum thickness(IVSTd),left ventricular posterior wall thickness(LVPWTd),left ventricular end-diastolic diameter(LVEDd),and the RRI for different segment of renal artery(the initial position of main renal artery,renal hilus,segment renal artery and interlobar artery)were collected and recorded.The differences of RRI and the ratio of RRI?0.7 between two groups in different segment of renal artery were compared.The subjects were divided into 4 groups according to different left ventricular geometry:Concentric Hypertrophy,Eccentric hypertrophy,Concentric remodeling,and normal geometry.RRI in different renal artery segments of four groups was compared.Subjects were divided into A(<5 years),B(5-10 years),and C(>10 years)according to the length of duration of hypertension.The RRI of threegroups were compared.The correlation between interlobar artery RRI and other parameters was observed.Normally distributed measurement data was analyzed by using t-test,non-normally distributed measurement data was analyzed by rank sum test,count data was analyzed by ?2 test,and two consecutive variables were analyzed by Pearson correlation test.The differences in RRI between three groups were tested using ANOVA.Independent predictor analysis was performed using Logistic.Results:1.To compared with HP group,the RRI of renal artery near the renal hilum and interlobar renal artery in HP+CHD group were significantly increased(P<0.05);while there was no significant difference in the RRI of the initial main renal artery and segment renal artery increased,but between two groups.2.At the initial main renal artery and main renal artery in the renal hilum,RRI of group C(> 10 years)was significantly higher than that of group A(<5years),group B(5-10 years),P <0.05;RRI of group A was higher than that of group B,There was no significant difference.The RRI of segment renal artery of group C was significantly higher then other two groups,P<0.05;the RRI of group B was higher than that of group A,but there was no significant difference between that two groups.RRI values of the interlobar renal artery,there was no significant difference between three groups.3.In the HP+CHD group,the RRI of the normal geometry group in the segmental renal artery was higher than that in the concentric hypertrophy group,P<0.05.However,there was no significant difference in RRI of other segment of the renal artery in patients with different left ventricular geometry.4.RRI of interlobar renal artery was positively correlated with age(P <0.01,R = 0.50),systolic blood pressure(P <0.05,R=0.19),pulse pressure(P<0.01,R=0.38),total cholesterol(P<0.05,R=0.17),negatively correlated with diastolic blood pressure(P<0.05,R=-0.21),e GFR(P<0.05,R=-0.183),RWT(P<0.05,R=-0.18).5.The RRI of interlobar renal artery and LDL were independent predictors of coronary heart disease.Conclusion:The RRI of essential hypertension patients with coronary heart disease are increased,people with longer duration of hypertension have higher RRI value.RRI of interlobar renal artery is an independent risk factor for coronary heart disease.