Influence of type A character on early renal impairment in elderly patients with essential hypertension and the protective effect of benazepril / 中华老年医学杂志

ABSTRACT

Objective To explore the influence of type A character on early renal impairment in elderly patients with essential hypertension and the protective effect of benazepril. Methods According to the type A behavior measuring scale, 80 cases with type A character and 80 cases without type A character were screened out from the elderly patients with essential hypertension. The patients received benazepril intervention with incipient dose of 10 mg daily, which increased gradually to the largest does of 20 mg daily within 1 month, The treatment lasted 6 months in order to make the patients achieve the normal blood pressure (BP). The general data, plasma angiotensin Ⅱ (AngⅡ )> urinary albumin excretion rate (UAER) and urinary β2-microglobulin (β2-MG) were measured at pretherapy and post-treatment respectively. Results There were no statistically significant differences at pretherapy between the two groups in age, gender, body mass index (BMI), blood urea nitrogen (BUN), creatinine (Cr), systolic pressure and diastolic pressure (all P>0.05). Ang Ⅱ [(60.3±11.6)mg/Lvs (55.8±10.2)mg/L], UAER[(83.3±23.3)μg/min vs. (75.7±16.3)μg/min] and β2-MG [(75.6±24.5)mmol/L vs. (66.0±19.4)mmol/L] were significantly higher in type A character group than in non-type A character group (t=2.598, 2.603, 2.742; P= 0.016,0.012, 0.008). TypeA character value of the two groups showed a positive correlation with Ang Ⅱ (r= 0.361, P=0.002), UAER (r=0.198, P=0.015) and β2-MG (r=0.202, P = 0.021). Only Ang Ⅱ (β=0.291, t=2.793, P= 0.008) was correlated to type A character value independently by multiple stepwise regression analysis. Before treatment in both of the type A character group and the non-type-A character group, there was a positive correlation between Ang II and UAER, (β2-MG, and obvious correlation in type-A character group. The systolic pressure, diastolic pressure, Ang Ⅱ , UREA and β2-MG were all decreased obviously in two groups post treatment. And the variable value of AngⅡ was also positively correlated with UAER (r=0.373, P=0.005; r=0.282, P=0.032), fr-MG (r= 0.385, P=0.003; r= 0.279, P=0.039) before and after treatment. Conclusions Type A character can aggravate injury of early renal function by certain stress systems in the elderly patients with essential hypertension and benazepril has better protective effect for it.