The Relationship Of The Blood Vascular Overload Index(VOI) And Resting Heart Rate(RHR) With Target Organ Damage (TOD) In The Essential Hypertensions With Metabolic Syndrome

Part one:The Relationship of the blood vascular overload index(VOI) with target organ damage(TOD) in the essential hypertensives with metabolic syndrome.Objective:The study was aimed to measure the blood vascular overload index(VOI) in hypertensives with MS and without MS,to search for subclinical target organ damage,We sought to evaluate whether VOI was associated with TOD in the essential hypertensives with MS。Methods:The study population was recruited from untreated hypertensive individuals who attended the Clinic of our Department during the period of 2006 Mar to 2008 Jan。All patients had undergone BP measurement and ECG,to calculate the blood vascular overload index(VOI),physical examination and routine biochemical analyses of blood and urineo All patients underwent extensive investigations searching for subclinical target organ damage(TOD),Including LVMI,CTIM and MUA。Result:1 Compared without MS-,age,gender,SBP,DBP was no significantly different;FBG,HDC-L,BMI,TG,VOI was significantly higher in the MS+ group(P≤0.001)。2.Hypertensive patients with the metabolic syndrome had a greater LVH(53.2±10.4 vs 44.2±11.9,P＜0.001);CIMT(0.71±0.15 vs 0.65±0.15,P＜0.001); LogACR(0.31±0.47 vs 0.06±0.54,P＜0.001)。and a greater VOI(64.03±2.15 vs 48.23±1.58,P≤0.001).3.Nivariate regression analysis show that VOI had significantly positive correlations with age(r=0.147;P≤0.033),SBP(r=0.154;P≤0.0181),BMI(r=0.220;P≤0.0029),TG(r=0.175;P≤0.089),and had significantly positive correlation with clinic TOD:LVMI(r=0.125;P≤0.0360), LogACR(r=0.257;P≤0.0012);CIMT(r=0.199;P≤0.0142)4.Multiple linear regression analysis show VOI was found to be independently associated with LVH,IMT(P≤0.002) and MUA(P≤0.01),after adjusting for age,gender,and FBG。Conclusions:1.Hypertensives with the metabolic syndrome had a greater VOI。It confirms that alterations in vascular structure and function as assessed by LVMI,CTIM and MUA were more frequent in patients with MS than in those without MS。2.The more pronounced cardiac involvement of hypertensives with MS was paralleled by an increased prevalence of microalbuminuria and carotid artery wall thickening or plaques,hypertensives with MS should underwent extensive investigations searching for subclinical organ damage(TOD)。3.Blood vascular overload index(VOI) is associated with organ damage in primary hypertension.With MS.The study strengthen the role of this index as a marker of risk and help to explain the high cardiovascular mortality reported in patients with high blood vessel overload index。 Part two:The Relationship of resting heart rate(RHR) with target organ damage (TOD) in the essential hypertensives with MSObjective:We sought to evaluate whether increasing resting heart rate has a greater impact on target organ damage in the essential hypertensives with MS。Methods:The subjects was the same as the former:A total of 187 hypertensive patients underwent ECG to measure resting heart rate,categorized in three groups(group A≤60;group B:60-80;group C:≥80)beat/min,according to resting heart rate。Result:1 Prevalence of LVH(32%vs 43%vs 59%,P≤0.01 for all),CIMT(5%vs 27%vs 56%,P≤0.05 for all) and MUA(21%vs 18%vs 19%,P≤0.05 for all) was significantly different in three groups.2 Prevalence rates of LVH,carotid plaques,and microalbuminuria were significantly higher in patients with MS than without MS((40%vs 37%,29%vs 15%,29%vs 9%,P＜0.05 for all)。3 Echocardiography values LVMI(176.8±52.3 vs210.9±57;182.2±49.8vs 217.8±59;200.8±44.1 vs 218.4±52.3);LVH(39.9±9.8 vs 45.1±10.6;47.2±11.9 vs 53.4±13.4;51.4±12.5 vs 55.3±12.8);CIMT(0.54±0.08 vs 0.61±0.11;0.70±0.12 vs 0.73±0.19;0.85±0.14 vs 0.92±0.17) showed a progressive increase from the Low-HR group to higher-HR group o Although,without showing an RHR-related increase for the prevalence of ACR(2.97±0.35 vs 6.39±1.22;2.42±1.25 vs 5.52±3.10;4.44+1.87 vs 10.30±3.22)。In all groups values were markedly altered in patients with MS as compared to those without MS,the difference being statistically significant(P＜0.05)。 Conclusions1.In conclusion,Resting heart rate is still strongly predictors of clinical target organ damage in essential hypertension with metabolic syndrome and that it maintains its role regardless of it is classic cardiovascular risk factor。2.Metabolism syndrome increases resting heart rate and the target organ damage in hypertension patient,simultaneously increasing resting heart rate followed by increased metabolic anomalies,indicated that metabolism syndrome and increasing resting heart rate have possibly the synergism to the target organ damage in hypertension patients。...