ABSTRACT
Objective To investigate the incidence of target organ damage in prehypertensive. Methods Two hundred and seventy-eight prehypertensive cases (prehypertensive group) and 136 normotensive cases(normotensive group) were involved in this study. The blood pressure,body height,weight and waist circumference were measured. Serum creatinine (SCr), urea nitrogen (BUN),uric acid(UA), fasting blood glucose (FBG), total cholesterol (TC), triglyceride(TG),low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and morning urine albumin concentration were detected by automatic biochemical analyzer. Left ventricular end-diastolic dimension (LVEDd), left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST), intima-media thickness (IMT) and plaque index (PI) were examined by ultrasonography. The incidence rates of plaque, left ventricular mass index (LVMI), relative wall thickness (RWT), glomerular filtration rate (GFR) and body mass index (BMI) were calculated. Results The proportion of ≥ 1, ≥2 and ≥3 kinds of risk factors was 71.9% (200/278),40.6%(113/278) and 13.7%(38/278) in prehypertensive group and 30.1%(41/136), 13.2% (18/136) and 5.9%(8/136) in normotensive group, and there was significant difference between the two groups (P＜0.05). Compared with normotensive group, the age,systolic pressure, diastolic pressure, FBG, waist, BMI, morning urine albumin, TG,TC,UA,LDL-C,IVST,LVPWT,RWT,LVMI,IMT,PI were higher, meanwhile the incidence rate of concentric reconstruction of left ventricular, concentric hypertrophy, eccentric hypertrophy and carotid plaque was higher, and the incidence rate of left ventricular normal configuration and GFR was lower (P＜0.01 or ＜0.05). Conclusion People with prehypertensive may accompany with many kinds of cardiovascular risk factors, and the incidence rate of target organ damage is significantly increased.
ABSTRACT
Objective To investigate the relationship between low-grade albuminuria and unfavourable cardiac geometric adaptations and left ventricular diastolic dysfunction in non-treated essential hypertensive(EH ) patients. Methods Three hundred and one patients of EH were divided into three groups acording to morning urine albumin concentration ( MU AC ): normoalbuminuria (NAU) group ( 107 cases,MUAC ＜ 10 mg/L) ;low-gradealbuminuria (LGAU) group ( 127 cases, MUAC 10-30 mg/L); microalbuminuria (MAU) group (67 cases, MUAC ＞ 30 mg/L). The blood pressure,body height and weight was measured for all the patients. The serum creatinine (SCr),blood urea nitrogen (BUN), uric acid (UA),fasting plasma glucose (FBG), plasma glucose 2 hours after oral glucose load (2hPG), total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer.Echocardiogram exarmination was performed to detect left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic posterior wall thickness (LVPWT) and interventricular septum thickness at end-diastole (IVST). Color Doppler ultrasound was used to measure indicators of left ventricular diastolic function, including peak E velocity of mitral diastolic flow (E) and peak A velocity of mitral diastolic flow ( A ), calculated E/A, measured the deceleration time of peak E ( DT ), and isovolumic relaxation time (IV RT ).Left ventricular mass index (LVMI) and relative wall thickness(RWT) were calculated by formula, and LVMI,RWT,left ventricular configuration diastolic dysfunction was compared. Results The level of MUAC had positive relationship with LVMI (r = 0.43 ,P ＜ 0.01 ). Compared with that in NAU group, IVST, LVPWT,RWT, LVMI increased (P ＜ 0.01 ), the ratio of left ventricular normal configuration decreased (P ＜ 0.01 ), the incidence of concentric reconstitution, concentric hypertrophy increased (P ＜ 0.05 ), A increased (P ＜ 0.05 ),and E/A decreased (P ＜ 0.01 ) in LGAU group. The total incidence of left ventricular diastolic dysfunction was 28.6%(86/301 ),12.1%(13/107),33.9%(43/127) and 44.8%(30/67)in NAU group,LGAU group and MAU group. The incidencerates of left ventricular diastolic dysfunction in LGAU group and MAU group were higher than that in NAU group (P ＜ 0.01 ). Conclusion LGAU is positively related to incidence of unfavourable cardiac geometric adaptations and left ventricular diastolic dysfunction in EH patients.
ABSTRACT
Objective To test the hypothesis that even low-grade microalbuminuria(LGAU) could predict subclinical target organs damage in untreated essential hypertensive(EH) patients.Methods Three hundred and one patients with EH were classified into three groups according to morning urine albumin concentration(MUAC): normoalbuminuria(NAU) group(n=107,MUAC