Effect Of Red Cell Distribution Width And Homocysteine On Cardiovascular Events In Newly Diagnostic Essential Hypertension

ObjectiveThe study aims to validate the effect of homocysteine(Hcy)and RDW on cardiovascular events(CVE)and investigate whether Hcy and RDW act as independent risk factors for cardiovascular events in newly diagnostic essential hypertension(EH).Also to investigate the correlation between Hcy and blood pressure variability in newly diagnostic essential hypertension.To investigate the Clinical significance of RDW in newly diagnosed hypersensitive patients and the correlation between RDW and variables in hypertension Methods:According to the diagnostic criteria of the current guidelines,The study reviewed 2361 patients with newly diagnosed EH in our Henan Province People's Hospital from March 2010 to July 2013.Selection criteria: newly diagnostic essential hypertension.Exclusion criteria: 1.used or is using antihypertensive drugs,vitaminB12,Leaf acid tablets 2.hypertension emergency 3.secondary hypertension 4.other cardiovascular system diseases 5.age less than 18 or older6.pregnant women 7.peripheral vascular disease 8.diabetes 9.thyroid disease10.autoimmune disease 11.chronic kidney disease 12.Diseases of the blood system13.malignant tumors 14.moderate anemia 15.severe hepatic insufficiency 16.anxiety and depression 17.other serious diseases.1.Tracking the incidence of cardiovascular events in these patients,includingcardiac death,angina,myocardial infarction,coronary artery reconstruction surgery,heart failure and stroke,peripheral vascular disease and transient ischemic disease.780 patients were followed up so far,24 patients died of cardiovascular events(other causes of death were not considered).The 804 patients were divided into two groups,cardiovascular events(CVE)group and no cardiovascular events(CVE)group,and risk factors were analyzed.According to the median of RDW(12.5%),it was divided into low RDW group and high RDW group,the correlation between RDW and other variables were analyzed.The effects of RDW and HCY on the occurrence of cardiovascular events in patients with primary hypertension were analyzed.2.Successively selected 416 patients from July 2012 to June 2013,the selection criteria exclusion criteria are the same as above.The patients were divided into three groups according to sereum Hcy,Group A 102 cases(Hcy<10.0umol/L),Group B144 cases(10umol/L / L ? Hcy < 15umol/L),Group C 170 cases(?15umol/L).Comparing the general conditions between the three groups,the relationship between serum homocysteine and blood pressure variability(BPV).Results1 This study comprised 419 men and 385 women with a mean age of 46.3 ± 10.9years.185 patients experienced CVE in our cohort.Among these,24 patients(12.9%)died because of CVE as previously described,and 115 patients had coronary events(62.2%),the remaining 46 patients(24.9%)experienced cerebrovascular events.Older patients were more liable to experience CVE(P=0.006).2 The CVE group had higher systolic blood pressure(P<0.001),higher creatinine(P=0.028),uric acid(P=0.016),homocysteine(P<0.001),hemoglobin(P=0.013)and red blood cell distribution width(RDW)(P<0.001)than group CVE.3 On multiple Cox regression analysis,it was found that the incidence of Hcy and RDW was closely related to the incidence of cardiovascular events.We also found that systolic pressure,LDL-C and uric acid are important biomarkers for cardiovascular events in patients with primary hypertension.4 In the there groups of essential hypertension of patients,the higher the Homocysteine level,the higher the 24 hours BPV,the difference was significant(P<0.05).correleation analysis showed serum Hcy level was positive correlated with24 h SBP BPV?24h DBP BPV.5 patients with higher RDW values tend to have older age(P = 0.041),BMI(P =0.003)and SBP(P = 0.017).With respect to laboratory results,the level of HDL-C in the high RDW group was lower,while the level of LDL-C,uric acid,Hcy,RBC count,and hemoglobin were significantly higher than that in the low RDW group(P < 0.05 for all).6 Correlation analysis identified that RDW values in patients with EH was positively correlated with age(r = 0.117,P = 0.036),BMI(r = 0.159,P = 0.022),LDL-C(r = 0.155,P = 0.026),uric acid(r = 0.178,P = 0.010),RBC count(r = 0.202,P = 0.004),hemoglobin(r = 0.209,P = 0.001),Hcy(r = 0.122,P = 0.028)and was negatively associated with HDL-C(r=-0.173,P = 0.017).In multivariate linear regression analysis,the correlation between RDW and Hcy disappeared.RDW was significantly associated with age(?=0.12,P=0.010),BMI(?=0.14,P=0.029),and LDL-C(?=0.26,P=0.006).Conclusions:1.Hcy and RDW were all significantly related to the incidence rate of CVE.Both RDW and Hcy are independent risk factors for CVE in newly diagnostic EH.2.The Higher Hcy can increase their blood pressure variability in newly essential hypertension patients.we should pay more attention to Hcy and BPV,in order to manage hypertension patients better.3 the correlation between RDW and Hcy disappeared.RDW was significantly associated with age,BMI,and LDL-C.