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Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.
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Objective To investigate the relationship between serum transforming growth factor- β1(TGF- β1) levels and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1. Methods The study subjects were divided into four groups:control group (30 cases); normal albuminuria group 1 (NA1 group with 12 cases, U MA/Cr < 10 μg/mg combined with type 2 diabetes);normal albuminuria group 2 (NA2 group with 19 cases,UMA/Cr 10-30 μg/mg combined with type 2 diabetes); microalbuminuria group ( MA group with 35 cases, U MA/Cr 31-300 μg/mg combined with type 2 diabetes). All these type 2 diabetic patients were suffering from diabetic retinopathy, and valsartan ( 80 mg/d) were medicated for those combined with hypertension. The serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay in all subjects. Results Serum TGF- β1 levels in three diabetes groups were (7.41 ± 2.68 ), ( 10.52 ± 4.10), (22.98 ± 43.74) ng/L, respectively, all of which were higher than those in control group [(4.25 ± 5.82) ng/L] (P < 0.05). There were significant differences in serum TGF- β1 levels among MA group, NA2 group and NA1 group (P < 0.05 ). Serum TGF-β1 levels in NA1 group with valsartan treatment significantly decreased compared with those without valsartan treatment (P < 0.05), whereas there was no significant reduction in NA2 and MA group with valsartan treatment (P > 0.05). Conclusions High serum TGF-β1 level may be associated with type 2 diabetes and early diabetic nephropathy. Early intervention of valsartan may be delay the onset and development of diabetic nephropathy by decreasing the serum TGF-β1 level.
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Objective To investigate the effect of different dose of atorvastatin on endothelium dependent vasodilatation function in hypertensives without hyperlipemia in attempt to verify the hypothesis of "beyond antihyperlipimia" effect of statins.Methods Fifty-five hypertensives without hyperlipemia were randomly to receive atorvastatin(10 mg/d,n=25)or(20 mg/d,n=30).Twenty-five normotensives were enrolled in control group.Serum cholesterol were determined.Flow-mediated dilation(FMD)and endothelium-independent dilatation(EID)were measured with high-resolution ultrosonography before and after 4 weeks atorvastatin.Results Compared with control group,FMD were significant decreased in hypertensives without hyperlipemia.FMD were improved after atorvastatin for 4 weeks(atorvastatin 10 mg group:7.5%?2.7% vs 11.5%?3.1%,P
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Objective To evaluate relationship and singnificance between metabolic syndrome (MS) and carotid atherosclerosis. Methods One hundred subjects were investigated,including 54 MS patients and 46 normal subjects.Body mass index,waist circumference,plasma lipid and fast glucose of all subjects were examined.Carotid intima-media thickness (IMT) was detected and plaque was scored with color Doppler ultrasound. Results The MS patients had significant higher carotid IMT,diameter,plaque index and plaque occurrence rate than those in normal ones. Conclusions The degree of carotid atherosclerosis in MS is much more severe than that in normal patients.The metabolic syndrome may promote the occurrence and the progress of atherosclerosis.Carotid ultrasonograohy may help diagnose coronary artery disease much earlier.
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The main methods examing artery function are measuing pulse wave velocity,augmentation index of reflected wave and the expansibility and compliance of specified artery by ultrasound examination.The methods evaluating artery structure includes the examination of the intima-media thickness,the detection of plaques and the calculation of ankle-brachial BP index.The above methods could be used to stratify the risk of hypertension patients.