Analysis Of Risk Factors Of Vascular Endothelial Dysfunction In Patients With Essential Hypertension

Objective:In recent years, the relationship between vascular endothelial dysfunction and atherosclerotic cardiovascular disease, as well as the risk factors for vascular endothelial dysfunction has become hot spots. The purpose of this study was to analyze the relationship between cardiovascular risk factors or metabolic factors and vascular endothelial dysfunction in patients with essential hypertension,and investigate the risk factors of vascular endothelial function in patients with essential hypertension.Merhods:We select 496 cases of patients with essential hypertension In in the hypertension ward of the first affiliated hospital of Shanxi Medical University from August 2014 to October 2015.We scan the brachial artery by high resolution ultasound probbe,and measure the brachial artery diameter at resting state and reactive congestion.Then we obtain the percentage of the diameter change.that is the brachial flow mediated dilation.According to the FMD value, the research objects are divided into three groups.The cardiovascular risk factors and metabolic factors were analyzed by single factor analysis and multiple linear regression analysis.Cardiovascular risk factors and metabolic factors among the groups were compared.The correlation between cardiovascular risk factors and FMD was also analyzed.Result:(1)Single factor analysis:History of hypertension and antihypertensive drugtaking history, smoking, age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, homocysteine, super sensitive C reactive protein,and fibrin have significant differences among groups. Then the differences has statistical significance.(P<0.05)(2)Linear linear regression analysis:FMD is negatively correlated with age(r=-0.407,P<0.001),Systolic blood pressure(r=-0.423, P<0.001), diastolic blood pressure(r=-0.117, P=0.009), blood glucose(r=-0.240, P<0.001),Total cholesterol(r=-0.186, P < 0.001), triglyceride(r=-0.121, P = 0.007), low density lipoprotein cholesterol(r=-0.113, P = 0.012), apolipoprotein B(0.133, P = 0.03), lipoprotein(a)(r=-0.134, P = 0.003),Phospholipids(r=-0.099, P=0.028), uric acid(r=-0.112,P=0.013), homocysteine(r=-0.118, P=0.009), high sensitive C reactive protein(r=-0.241, P<0.001), plasma fibrinogen(r=-0.268, P<0.001).FMD is negatively positively correlated with high density lipoprotein cholesterol(r=-0.137, P=0.002),apolipoprotein A(r=-0.134, P=0.003).(3)multiple linear regression analysis:Smoking(beta =-0.397 all P < 0.001, SBP(beta =-0.361, P < 0.001), age(beta =-0.361, 0.001), total cholesterol(=-0.302 beta, P< 0.001), LDL-C(=-0.206 beta P = 0.003), and hs CRP(=-0.137 beta P < 0.001), and fasting blood glucose(=-0.128 beta, P < 0.001) and Hcy(beta =-0.104(P = 0.004) are indenpendently correlated with FMD,and the degree of relation decreased gradually.Conclusions:Smoking, systolic blood pressure, age, total cholesterol, low density lipoprotein cholesterol, high-sensitivity C reactive protein, fasting blood glucose and homocysteine are independent risk factors of vascular endothelial dysfunction in patients with primary hypertension.atherosclerosis can be induced by the injury of vascular endothelial function from cardiovascular risk factors or metabolic factors.