RESUMO
Background: Hypertension patients with primary aldosteronism (PA) have a higher risk of cardiovascular complications than blood pressure-matched essential hypertension (EH) patients. The cause may be closely related to inflammation. We explored the correlations between leukocyte-related inflammation parameters and plasma aldosterone concentration (PAC) in PA patients and clinical characteristics-matched EH patients. Methods: A total of 346 PA and 346 sex, age and 24-h blood pressure-matched EH patients at the 2nd Affiliated Hospital of Nanchang University from January 2020 to June 2021 were enrolled in this study. The differences and correlations of aldosterone and leukocyte parameters between the two groups were analyzed. Results: Compared with EH patients, the lymphocyte count was significantly lower (P = 0.004), the neutrophil-lymphocyte ratio (NLR) (P = 0.023) and the monocyte-lymphocyte ratio (MLR) (P = 0.037) were significantly higher in PA patients. Linear regression analysis and multivariate regression analysis identified that lymphocyte count, NLR and MLR were significantly and independently correlated with PAC in PA patients, and the correlations were stronger with increasing levels of aldosterone. However, in EH patients, only NLR maintained an independent correlation with PAC. Conclusion: Leukocyte-related inflammation parameters, including lymphocyte count, NLR, and MLR, were significantly and independently correlated with PAC in PA patients. The correlations were stronger with increasing levels of aldosterone. However, the above correlations were not always present in patients with EH matched for clinical characteristics.
RESUMO
OBJECTIVE: To provide an up-to-date synthesis of available data, and to quantify the effect of highly selective beta-1 blockers on glucose metabolism in patients with essential hypertension and type diabetes mellitus (T2DM) by using pooled analysis techniques. METHODS: Cochrane Library, PubMed, MEDLINE, and EMBASE databases were searched from inception to July 2013 in the Third Affiliated Hospital of Nanchang University, Nanchang, China. We collected randomized controlled trails reporting on the effect of highly selective beta-1 blockers on glucose metabolism in patients with hypertension and type 2 diabetes. Data was screened, evaluated, and extracted by 2 independent researchers according to the inclusion and exclusion criteria. Meta-analysis was conducted using RevMan5.0 software. RESULTS: Seven trials were enrolled in the meta-analysis including a total of 1354 patients. Meta-analysis results revealed that when compared with the control group, selective beta-1 blockers were associated with a higher fasting blood glucose (weighed mean difference: 0.21, 95% confidence interval [CI]: 0.16-0.27; p<0.00001). But results revealed no significant difference in glycosylated hemoglobin (weighed mean difference: 0.13, 95% CI: -0.11 to 0.37; p=0.28), fasting insulin (weighed mean difference: -1.13, 95% CI: -4.27 to 2.01; p=0.48), and gain in body weight (weighed mean difference: 1, 95% CI: -1.08 to 3.08; p=0.35). CONCLUSION: Selective beta-1 blockers were associated with elevated fasting blood glucose. Thus, it should not be used for patients with essential hypertension and diabetes.
