ABSTRACT
Objective With a computer-assisted program,retinal vascular calibers were measured quantitatively.In this study the relationship between retinal vascular calibers and components of the metabolic syndrome was examined.Methods A total of 450 hypertensive patients were collected.Medical history,physical examination,blood tests,and retinal photographs were taken.Retinal vascular calibers were measured quantitatively from digital retinal photographs.In the hypertensive population the associations of retinal vascular calibers with components of the metabolic syndrome were described,and the factors that influenced retinal vascular calibers were analyzed.Results In the enrolled population,mean age was (57.53 ± 10.01) years,mean systolic blood pressure (138 ± 17) mm Hg(1 mm Hg =0.133 kPa),diastolic blood pressure (84 ± 10) mm Hg.Mean central retinal arteriolar equivalent(CRAE) was(129.26 ± 12.68) μm,and mean central retinal venular equivalent (CRVE) (198.25 ± 18.37) μm.After adjusting for age,gender,etc,CRAE in group with poor blood pressure control was smaller than that in the group with good blood pressure control [(126.45 ± 15.74) μm vs (130.30 ± 11.30) μm,P =0.029].CRAE tended to be narrower with worsened blood pressure control (P =0.075).CRVE was smaller in patients with normal high density lipoprotein-cholesterol (HDL-C) than in those with abnormal level [(197.36 ±17.62) μm vs (203.07 ± 21.52) μm,P =0.040].The diastolic blood pressure was raised along with the decreasing CRAE(P=0.009).And the HDL-C level was reduced as CRVE was increasing(P=0.042).Old age (r =-0.090,P=0.013) and poor blood pressure control(r=-0.098,P=0.038) were independent risk factors for narrow CRAE,while lowered HDL-C (r =0.105,P =0.024) and smoking (r =0.141,P =0.010) were independent risk factors for wide CRVE.Conclusions Narrow CRAE was related to poor blood pressure control,while wide CRVE was related to lowed HDL-C.Aging and poor blood pressure control were independent risk factors for narrow CRAE,while lowed HDL-C and smoking were independent risk factors for wide CRVE in the hypertensive patients.
ABSTRACT
ObjectiveTo evaluate the priority application of thin adrenal CT scanning in out-patients with hypertension for early diagnosis of adrenal hypertension.MethodsThe patients with hypertension were collected from January to August 2009,in whom the secondary hypertension ( including endocrine and renal hypertension) and malignant cancers were excluded.All patients accepted the adrenal CT scan firstly,and then the patients with the positive result of morphological abnormalities in the adrenal CT( including adenoma and hyperplasia)were evaluated for endocrine function of adrenal glands.Results A total 362 cases of hypertension were studied,in.cluding 162 males and 200 females.The average age was (60.9 ±9.3 ) year-old,the average duration of hypertension was ( 13.8 ±5.3 ) year.After adrenal thin layer scanner CT scan,35 patients ( 9.6％ ) with adrenal abnormalities were found.Endocrine functional assessments of adrenal glands were carried out among these patients,17 cases (4.7％) with functional lesions were diagnosed,including 14 cases(3.9％ )with primary hyperaldosteronism,2 cases(0.6％ )with Cushing's syndrome,and 1 case ( 0.3％ ) with pheochromocytoma.Conclusion This study revealed that the percentage of adrenal lesions in outpatients with hypertension was 9.6％.The percentage of adrenal hypertension was 4.7％.Thin layer CT scan seems to effectively screen the adrenal hypertension with adrenal lesions,and would be helpful to the diagnosis of endocrine hypertension.