Analysis The Synergic Effect Of Renin And Aldosterone On Left Ventricular And Atrial Structure And Left Ventricular Function In Essential Hypertension With Obstructive Sleep Apnea Syndrome Patients

Objective:To study the relationship between renin and aldosterone with left ventricular and atrial structure and left ventricular function in essential hypertension with obstructive sleep apnea syndrome(OSAHS)patients.Method:Select277essential hypertension with obstructive sleep apnea syndrome patient including197 males and 80 females from the First Affiliated Hospital of Xinjiang Medical University.The patients were divided into four groups according to the PRA and PAC levels: normal PRA and PAC(n=74),high PRA and normal PAC(n=113),normal PRA and high PAC(n=22),high PRA and high PAC(n=68).The parameters of left ventricular and atrial structure and left ventricular systolic and diastolic function determined by echocardiogram were compared among each groups.Renin and aldosterone levels were assessed by radioimmunoassay method.One way analysis of variance and the multi-factor Logistic regression analysis were used to study the synergic effect of renin and aldosterone on left ventricular and atrial structure and left ventricular function in essential hypertension with obstructive sleep apnea syndrome(OSAHS)patients.Results:(1)The contrast in four groups of basic data: the differences in 24 hours average diastolic blood pressure,AHI were statistically significant(P<0.05)?(2)Echocardiographic index contrast: the differences in LAD,LVEDD,IVST,LVPWT,LVMI,E/A were statistically significant(P<0.05)?LAD?LVEDD?IVST?LVPWT in high PRA high PAC group were higher than those in normal PRA and normal PAC group(P<0.083).Furthermore,LVEDD,IVST were higher in high PRA and high PAC group than those in high PRA and normal PAC group(P<0.0083).LVMI in high PRA high PAC group was higher than that in normal PRA and normal PAC group and high PRA and normal PAC group(P<0.05).(3)The multi-factor Logistic regression analysis showed that BMI(OR=2.756,95%CI 1.604~4.738),high PRA and high PAC(OR=2.377,95%CI 1.038~5.446)were the influencing factors of LAD;Gender(OR=0.283,95%CI 0.134~0.601)),BMI(OR=2.058,95%CI 1.198 ~ 3.533),AHI(OR=2.776,95%CI 1.364 ~ 5.650),High PRA and high PAC(OR=3.222,95%CI 1.377 ~ 7.537)were the influencing factors of LVMI;Age(OR=2.859,95%CI 1.943~4.206)is the influencing factors of E/A.Conclusion :The combination of renin and aldosterone determines impairment of left ventricular and atrial structure and left ventricular function in essential hypertension with obstructive sleep apnea syndrome(OSAHS)patients,especially the synergic effect of hyperreninemia and hyperaldosternism is obvious.