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Objective To analyze the correlation between vitamin D levels and vascular endothelial function and plasma renin activity (PRA) in hypertensive patients.Methods 415 patients with essential hypertension admitted to our hospital from January 1 to December 2017 were selected as the experimental group.142 healthy subjects who received physical examination and met the included indicators were selected as the control group.The blood biochemical indexes and the 25 (OH) D contents in the blood of two groups were detected and analyzed.The experimental group was divided into vitamin D mild deficiency group (15-30 mmol/L),severe deficiency group [25 (OH) D ＜ 15 mmol/L] and normal group [25 (OH)D ＞ 30 mmol/L] according to vitamin D content.The endothelial function (RHI value) and renin were compared in the three groups,and multiple linear regression analysis was performed on endothelial function and orthotopic renin activity and related factors.Results The diastolic blood pressure,vitamin D content and blood lipid biochemical indexes of the experimental group and the control group were significantly different (P ＞ 0.05).The higher the vitamin D content,the lower the plasma renin activity PRA;the RHI value of the vitamin D severe deficiency group was lower than the vitamin D normal group [(1.4 ±0.15)mmol/L vs (1.6 ± 0.20) mmol/L] (P ＜ 0.05).Vitamin D was negatively correlated with 24 hours systolic blood pressure (24 h SSD),the standard deviation of 24 hours diastolic blood pressure (24 h DSD),the Standard deviation of daytime systolic blood pressure (dSSD),the Standard deviation of daytime diastolic blood pressure (dDSD),the Standard deviation of nighttime systolic blood pressure (nSSD),the Standard deviation of nighttime diastolic blood pressure (nDSD) (P ＜ 0.05),and positively correlated with the decrease of night systolic blood pressure and night diastolic blood pressure.Vitamin D and total cholesterol were independent influencing factors of endothelial function (P ＜ 0.01).Vitamin D and 24 h mean heart rate were independent influencing factors of orthostatic renin activity (P ＜ 0.01).Conclusions The low vitamin D content in patients with essential hypertension affects endothelial function and plasma renin activity,which should be paid more attention in clinical practice.
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Objective To investigate the correlation between epicardial fat thickness and non dipper hypertension.Methods A total of 150 subjects was included in the study,of which 50 were in the non dipper hypertension group,the same in the non dipper hypertension group and the healthy control group.History collection and routine laboratory tests,ultrasonic measurement of epicardial fat thickness,and 24 hour ambulatory blood pressure monitoring were carried on all subjects.Epicardial fat thickness between groups was compared to primarily analyze the correlation of epicardial fat thickness and non dipper type hypertension.The optimal screening positive value in epicardial fat thickness of non dipper type primary hypertension was obtained by receiver operating characteristic (ROC) curve and maximum Youden index.Results When non dipper hypertension group and non-dipper hypertension group were compared,epicardial fat thickness was significantly increased [(6.30 ± 0.94) mm vs (5.92 ± 0.75) mm,P ＜ 0.05],as compared dipper hypertension group to healthy group,the epicardial fat thickness was significantly increased [(5.92 ±0.75)mm vs (5.50 ±0.13)mm,P ＜0.05].Epicardial fat thickness and non dipper type primary hypertension were linearly related (r =0.43,P ＜ 0.05),and epicardial fat thickness in diagnosis of non dippers primary hypertension optimal screening positive value was 6.01 mm.Conclusions There is a close relationship of epicardial fat thickness and non dipper hypertension.
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Objective To investigate the correlation between carotid artery plaque and blood pressure variability (BPV) in elderly patients with hypertension.Methods One hundred sixty elderly patients with hypertension were divided into plaque and non-plaque groups according to the results of carotid artery ultrasonography.All the patients were measured by ambulatory blood pressure monitoring.The mean blood pressure,mean pulse pressure,and blood pressure variability coefficient of two groups were calculated and compared during whole day,daytime,and nighttime.The related factors of carotid artery plaque were analyzed by multivarite logistic regression analysis.Results The 24 h systolic blood pressure standard deviation,daytime and nighttime of systolic blood pressure standard deviation,daytime diastolic blood pressure standard deviation of plaque group were higher than those of non-plaque group (P ＜ 0.05).The 24 h systolic blood pressure variation (24 h SBPV) and night systolic blood pressure variation (nSBPV) were higher than those of non-plaque group (P ＜0.01).Multivariate regression analysis results showed that carotic artery plaque was associated positively with 24 h BPV and blood pressure variability coefficient of nighttime (P ＜ 0.05).Conclusions The elderly hypertensive patients with carotid artery plaque is associated positively with 24 h systolic blood pressure variability coefficient and blood pressure variability of nighttime.
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Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment.