Changes Of Pulse Wave Velocities And Endothelial Micro-Particles In Patients With Stage 1 Essential Hypertension Before And After The Treatment

Objectives1. To observe changes in Pulse wave velocities (PWV), Plasma endothelial micro-particles (EMPs), serum endothelin-1 (ET-1), Interleukin 6 (IL 6),high sensitivity C-reactive protein (hsCRP), and Nitric oxide (NO) in patients with stage 1 essential hypertension before and after the treatment.2. To investigate whether there is a correlation between changes in PWV and changes in EMPs, serum ET-1, HsCRP, IL-6 and NO before and after antihypertensive treatment in order to assess the role of monitoring PWV in the prevention of atherosclerosis in patients with early hypertension.MethodsThirty-three(33) patients with stage 1 hypertension were enrolled into the study.ShiHui da (benzene sulfonic acid levorotatory amlodipine) 2.5 mg once daily was administrated as the first step in therapy. If the target BP(< 140/90mmHg) was not achieved within one week, the Pulitzer (Perindopril) 4mg once daily was added, If the target BP was still not achieved in one week, DaBiaoZhe (hydrochlorothiazide) 125 mg/day was added.If target BP still cannot attained,the patients was dropped from the StudyPWV, plasma EMPs, serum ET-1, HsCRP,IL-6 and NO were measured pre-therapy and at 30 days,60 days,120 days post-therapyStatistical analysis was performed with SPSS13.0 according to the statistical analysis plan.Results1. Both SBP and DBP decreased significantly in all the 33 subjects with phase 1 essential hypertension after the treatment with antihypertensive drugs.The decrease in BP was statistically significant (P<0.05). There was no significant difference in both SBP and DBP between 120 days and 60 days or 30 days post-therapy2. Comparing with the values pre-therapy, PWV, levels of plasma EMPs serum ET-1, and hsCRP progressively decreased during therapy, while the levels of blood NO progressively increased (P<0.01) immediate post-therapy.The level of IL-6 immediate post-therapy was lower than at pre-therapy, but there was no significant difference between 60 days and 120 days post-therapy.3.Analysis by the Pearson's coefficient of correlation indicates a statistically significant positively relationship between levels of PWV and SBP, DBP, plasma EMPs,serum ET-1, HsCRP,and IL-6 levels (r=0.846,0.619,0.803,0.801 0.583, respectively, P<0.001,).There was a statistically significant negatively correlation between PWV and serum NO (r=-0.482, P<0.001)4. The logarithm of EMPs level was positively correlated with SBP,DBP, ET-1, HsCRP and IL-6 levels(r= 0.597,0.428,0.454,0.569,0.567 respectively, P<0.001), and negatively correlated with NO level (r=-0.127, P<0.001)Conclusion1. The PWV, plasma EMPs,serum ET-1, hsCRP,and IL-6 levels in patients with stage 1 essential hypertension significantly decreased statistically after treatment compared to before treatment.2. The PWV positively correlated with S B P, D B P, plasma EMPs,serum ET-1, hsCRP,and IL-6 levels; and negatively correlated with serum NO.3. The logarithm of EMPs level positively correlated with S B P, D B P, serum ET-1, hsCRP,and IL-6 levels; and negatively correlated with serum NO.4. This study suggests that monitoring PWV plays an important clinical role in evaluating and preventing the process of atherosclerosis in patients with stage lessential hypertension.