Association Of Blood Pressure Levels And Other Factors With Early Renal Injury In Hypertensive

Object: Explore the correlation between systolic blood pressure,diastolic blood pressure,duration of hypertension,gender,age,body mass index and renin angiotensin converting enzyme inhibitors used with Urine Albumin/Creatinine Ratio(UACR)in hypertensive.To analyze the related factors affecting early renal vascular injury in hypertension patients.And provides a theoretical basis for the clinical development of individualized treatment for delayed renal injury.Methods: According to the diagnostic criteria for hypertension in China hypertension prevention guide 2010.A total of 599 patients diagnosed with hypertension were consecutively selected from January 2016 to December 2017 in the first affiliated hospital of hainan medical college and so on.Measurement diastolic blood pressure(DBP),systolic blood pressure(SBP),height,weight.Calculated body mass index.Record the basic parameters of patients included sex,age,hypertension duration,and use of Renin-Angiotensin-System Inhibitors(RASI).Urinary albumin(UA)and creatinine(CR)measured by urine analysis strip test and Calculate UACR.Microalbuminuria was defined as urine albumin/creatinine ratio 30~300mg/g according to the diagnostic standards of KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Pearson correlation was used to analyze diastolic blood pressure,systolic blood pressure,hypertension,gender,age,body mass index and RASI used impact on UACR.Results: 1.DBP has a significant correlation with UACR,in female patients(r=0.13 P=0.02),BMI ? 25 patients(r=0.192 P=0.007),Age 55 or less patients(r=0.303 P=0.006)and patients with hypertension less than 10 years(r=0.162 P=0.002).(P<0.05)2.The course of disease has a significant correlation between UACR in patients of Age 55 or less patients(r=0.445 P=0.005),BMI?24.9 patients(r=0.177 P=0.004)and adiastolic blood pressure >70mm Hg(r=0.162 P=0.002).(P<0.05)3.There was a significant correlation between age and UACR in male patients(r=0.144 P=0.017)and BMI?25 patients(r=0.186 P=0.009).(P<0.05)4.Multiariable Logistic regression analysis showed that diastolic pressure is the protection factor in hypertension and diabetes mellitus(OR = 0.967,P <0.01),urine proteinas a risk factor for hypertension and diabetes mellitus(OR = 1.052,P < 0.05).Conclusion: 1.There was a significant correlation between diastolic blood pressure and UACR in female,overweight or Age 55 or less patients and hypertension in patients with clinical course < 10 years patients.In these four groups diastolic blood pressure is the significant factors affecting the early renal vascular injury.Controlling the diastolic pressure can delay kidney disease.2.The duration of hypertension was significantly correlated with the UACR of patients under 55 years of age,normal weight,and diastolic blood pressure >70mm Hg.Age was significantly associated with UACR in men and obese patients.It was suggested that the course of of hypertension significantly affected the early renal injury in patients ? 55 years old,BMI?24.9 and diastolic blood pressure >70mm Hg,and the renal vascular injury was more obvious in men and obese patients as the age changed.3.Diastolic blood pressure is a protective factor in patients with hypertension and diabetes mellitus.Urinary protein is a risk factor,suggesting that reasonable control of diastolic blood pressure and lower urinary protein may play an important role in preventing renal injury.