Correlationship Of Vascular Disease With Plasma Levels Of EsRAGE And PTX3 In Patients With Primary Hypertension

Objective: To investigate the association between serum pentraxin-3(PTX3) and endogenous secretory advanced glycation end products receptor(es RAGE) concentrations and atherosclerosis in elderly hypertensive patients.Methods: Overall, 587 elderly patients that hospitalized at the PLA 252 Hospital from July 2013 to May 2014 were included to the study. Patients were divided into simple hypertension group and control group. Hypertension group was divided into hypertensives with achieved target BP goal and hypertensives not achieved target goal groups. According to the coronary angiography, the hypertension group were divided into coronary heart disease(CHD) group and non-CHD group. The severity of coronary stenosis was evaluated by Gensini scores. The CHD group was divided into single vessel, double vessel and multiple vessel disease groups according to the numbers of lesioned coronary artery. Cardiovascular risk factors, including age, sex, waist circumference, BMI, blood pressure blood lipid and blood glucose, etc, were measured in all patients. Plasma PTX3 and es RAGE levels were determined by enzyme linked immunosorbent assay(ELISA). Pulse wave velocity(PWV) and ankle brachial index(ABI) were measured using a volume plethysmographic apparatus. By investigating the relationship among cardiovascular risk factors, atherosclerosis and serum PTX3 and es RAGE concentrations, we analyze the major factors that affect arterial elasticity to probe new targets for effective intervention. The SPSS 17.0 was used for the statistical analysis. P<0.05 indicates a significant difference.Results: 1 The baseline informationAge, gender, waist circumference, BMI, blood lipid and blood glucose hadno statistically significance between the hypertension group and the control group. According to whether having CHD, The hypertension group was divided into CHD group and non-CHD group. Compared to the non-CHD group, the levels of waist circumference, total Cholesterol significantly higher in CHD group(P<0.05). On the other hand, HDL level was significantly lower(P<0.05). And age, gender, BMI, blood glucose, TG and LDL had no significant difference. 2 The relationship between atherosclerosis and plasma PTX3 and es RAGE levels in elderly hypertensive patients 2.1 The general situation587 patients from the PLA 252 Hospital, average ages 66.5±5.6 years old, 237 males and 350 females, 382 cases of hypertension, 153 positive cases of coronary angiography, 27 cases without CHD. 119 patients were determined plasma PTX3 and es RAGE levels, including 106 cases of hypertension, 63 cases of hypertension with CHD and 13 cases the control group. 2.2 The relationship between hypertension and PWV, ABICompared with control group, the level of PWV in hypertension group was higher(P<0.05), while the difference of ABI level between control group and hypertension group was not statistically significant(P>0.05). The level of PWV in patients whose blood pressure not achieved the target goal was higher than that in hypertensives with achieved target BP goal(P<0.05). The difference of ABI level between hypertensives with achieved target BP goal and not achieved the target goal was not statistically significant(P>0.05). 2.3 The relationship between hypertension and serum PTX3 and es RAGE concentrationsThere was markedly different about the level of PTX3 and es RAGE concentrations between hypertension group and control group(P<0.05). The difference of PTX3 and es RAGE concentrations between hypertensives with achieved target BP goal and not achieved the target goal was not statistically significant(P>0.05). 2.4 The relationship between levels of PWV and ABI and plasma PTX3 and es RAGE concentrationsPlasma PTX3 level was markedly higher in PWV >1700cm/s than PWV <1700cm/s(P<0.05), while level of es RAGE was lower in PWV >1700cm/s than that in PWV <1700cm/s(P<0.05). Serum PTX3 concentration was markedly lower in ABI<0.9(P<0.05), but Serum es RAGE concentration was not statistically significant(P>0.05). 2.5 In the simple correlation analysis, PWV was positively related with age, SBP, DBP, PP, FPG, TG, TC and LDL, while ABI was negatively correlated with LDL and Gensini scores. PWV was not significantly correlated with BMI, HDL, Gensini scores. ABI was observed no correlation with age, BMI, SBP, DBP, PP, FPG, TG, TC and HDL. The simple correlation analysis showed that Plasma PTX3 was positively correlated with SBP and PP; while Plasma es RAGE was negatively correlated with SBP and PP. Significant correlation was observed between the concentrations of PTX3 and es RAGE. Both of Plasma PTX3 and es RAGE concentrations were not correlated with age, waist circumference, BMI, DBP, blood glucose, blood lipid and Gensini scores. 3 The influence of hypertension+CHD on the arterial vascular disease and plasma PTX3 and es RAGE levels 3.1 The relationship between CHD and PWV, ABIThere was markedly different about the level of PWV between CHD group and non-CHD group(P<0.05), while the difference of ABI level between CHD group and non-CHD group was not statistically significant(P>0.05). In CHD group, the level of PWV as well as ABI level among the single vessel, double vessel and multiple vessel was not statistically significant(P>0.05). 3.2 Relationship between serum PTX3 and es RAGE concentrations and CHDAccording to whether having CHD, The hypertension group was divided into CHD group and non-CHD group. Serum PTX3 and es RAGE concentrations were markedly different between CHD group with non-CHD group(P<0.05). In CHD group, levels of PTX3 and es RAGE among the single vessel, double vessel and multiple vessel were statistically significant(P<0.05). 3.3 In the simple correlation analysis, ABI was negatively correlated with Gensini scores, while PWV was not significantly correlated with Gensini scores. Both of Plasma PTX3 and es RAGE concentrations were not correlated with Gensini scores.Conclusions:1 Higher PTX3 levels, lower es RAGE levels and decreased arterial distensibility coexist in elderly hypertensive men.2 The progress in atherosclerosis may, at least in part, be associated with an BP-related elevation in plasma PTX3 and es RAGE concentrations.3 Plasma PTX3 and es RAGE concentrations were markedly correlated with coronary heart disease and the scope of coronary artery lesion.