Correlation Between Central Arterial Pressure And Renal Damage In Newly Diagnosed Hypertensive Patients

Objective:This study is couduted to explore the correlation between central arterial pressure and renal damage in young and middle-aged patients with hypertension,and to provide a clinical basis for predicting early renal damage caused by hypertension,early intervention to avoid and reduce the occurrence of end-stage renal disease.Methods:The patients newly diagnosed essential hypertension were enrolled in the Department of Cardiology,Sichuan Provincial People's Hospital from November 2017 to January 2019.The patients were collected for age,sex,blood pressure,blood lipids,urine microalbumin/creatinine(ACR),and small kidney.Clinical data such as ball filtration rate(eGFR),all patients were grouped according to eGFR and ACR.eGFR was divided into three groups according to the tertile of the numerical distribution,A,B,C,42 cases in group A,eGFR?109.30ml/min/1.73m~2,44 cases in group B,94.69ml/min/1.73m~2?eGFR<109.30ml/min/1.73m~2,42 patients in group C,eGFR<94.69 ml/min/1.73m~2.ACR was divided into ACR normal group:ACR:0.0-30.0ug/mg,ACR abnormal group:ACR:>30.0ug/mg.The correlation between clinical data such as age,gender,blood pressure and blood lipids and eGFR and ACR were analyzed.Results:1.The average age of patients(54.56±9.17)years old,70(54.7%),49(38.3%),and 9(7.0%)patients with grade 1,2,and 3 hypertension.2.Groups A,B,and C in eGFR group included gender,age,BMI,fasting blood glucose,low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C),total cholesterol(TC),There were no significant differences in triglyceride(TG),serum cystatin C(Cys-C),brachial artery diastolic blood pressure(DBP),and reflected wave enhancement index(AIx)(P>0.05).The systolic blood pressure(SBP),pulse pressure difference(PP),central systolic pressure(CSBP),and serum creatinine(Scr)levels were statistically significant(P<0.05).Pearson correlation analysis showed that eGFR was associated with age(r=-0.269,P<0.01),SBP(r=-0.440,P<0.01),PP(r=-0.301,P<0.01),CSBP(r=-0.497).,P<0.01),Scr(r=-0.326,P<0.01),Cys-C(r=-0.197,P<0.01)showed a negative correlation.Multivariate stepwise linear regression analysis showed that CSBP,age,and Scr entered the regression equation.3.There was no significant difference in gender,age,BMI,SBP,PP,CSBP,fasting blood glucose,LDL-C,HDL-C,TC,TG,AIx,Scr between ACR normal group and ACR abnormal group.P>0.05);DBP and Cys-C levels were statistically significant(P<0.05).Spearman correlation analysis showed that ACR and SBP(r=0.321,P<0.05)and PP(r=0.211,P<0.05).),CSBP(r=0.381,P<0.05)showed a positive correlation and negative correlation with eGFR(r=-0.289,P<0.05).Multivariate stepwise linear regression showed that eGFR and CSBP entered the regression equation.Conclusion:CSBP is an independent predictor of early renal damage in young and middle-aged hypertensive patients,and its elevation can lead to decreased eGFR and elevated ACR.