The Correlation Of Blood Pressure Circadian Rhythm And Serum Homocysteine With The Early Renal Damage In Patients With Essential Hypertension

Objective:To investigate the correlation of blood pressure circadian rhythm and serum homocysteine(Hcy) with the early renal damage in patients with essential hypertension(EH).Methods:Three hundred and sixteen patients who were diagnosed with EH in patients of Second Hospital of Shanxi Medical University from December 2012 to December 2014 were selected.The above patients would be taken the 24 hours ambulatory blood pressure and done Hcy, who can be divided into four groups based on the above result: Dipper and H type hypertension group(89 cases), Dipper and non-H type hypertension group(69 cases),non-Dipper and H type hypertension group(78 cases) and non-Dipper and non-H type hypertension group(80 cases).Microalbuminuria(m ALB) and Cystatin C(Cys C) were measured on the next day of Hospitalization. Comparing the differences of m ALB and Cys C in these groups.Results:1. The contents of microalbuminuria in Dipper and non-H type hypertension group,non-Dipper and H type hypertension group, Dipper and H type hypertension group and non-Dipper and non-H type hypertension group were different(16.40±4.44) vs(83.56±4.40) vs(35.96±4.13) vs(37.38±3.80)mg/L. There were significant differencesamong four groups(F = 2430.029, P < 0.001).2. The contents of Cys C in Dipper and non-H type hypertension group, non-Dipper and H type hypertension group, Dipper and H type hypertension group and non-Dipper and non-H type hypertension group were different(0.89±0.19) vs(1.85±0.17) vs(1.21±0.17)vs(1.33±0.15) mg/L. There were significant differences among four groups(F = 563.655,P < 0.001).3. Through factorial design the blood pressure circadian rhythm disorders and high blood homocysteine cause the interaction to m ALB and Cys C.4. Through the multiplication model calculation, the blood pressure circadian rhythm and blood homocysteine had positive interaction.Conclusion:Blood pressure circadian rhythm disorders and high serum homocysteine may cause the early renal damage in the patients with essential hypertension, which can create the synergy.Therefore the treatment of patients with hypertension should attach more attention to the management of blood pressure circadian rhythm and serum homocysteine, and take the intervention timely, so as to provide theoretical basis for the management of the early renal damage in patients with essential hypertension.