Résumé
Objective To investigate brachial artery endothelial function and carotid intima-media thickness (IMT) in patients with H-type hypertension.Methods One hundred and twenty patients with newly-diagnosed mild to moderate hypertension were enrolled in the study,including 58 cases with normal homocysteine (HCY) level (＜ 10 μmnol/L,non H-type group) and 62 cases with high HCY (≥10 μ moL/L,H-type group).Systolic pressure,diastolic pressure,blood lipid (TC,TG,LDL-C,HDL-C),fasting plasma glucose and two hours postprandial plasma glucose were measured in all patients.Brachial artery endothelial function and carotid IMT were determined with ultrasonography and compare between two groups.The factors related to brachial artery endothelium-dependent dilation (EDD) and carotid IMT were analyzed with multiple linear stepwise regression.Results Compared with non H-type group,the brachial artery EDD was reduced [(6.85 ± 0.77) ％ vs.(5.98 ± 0.85) ％,t =2.552,P =0.041] and carotid IMT was increased [(0.90±0.13)mm vs.(1.01 ±0.17)mm,t =2.426,P=0.048] in H-type group.The multiple linear stepwise regression analysis showed that EDD was negatively correlated to systolic pressure,diastolic pressure,fasting plasma glucose,two hours postprandial plasma glucose and HCY (r =-0.685,-0.654,-0.571,-0.627,-0.529,respectively,all P ＜ 0.05).IMT was positively related to systolic pressure,diastolic pressure,TC,TG,LDL-C and HCY (r =0.596,0.584,0.652,0.665,0.673,0.541,respectively,all P ＜ 0.05).Conclusion Patients with H-type hypertension are at a higher risk to arteriosclerosis than those with non H-type hypertension,which may be related to high HCY levels.