Research On Vascular Endothelial Function And Its Influencing Factors In Newly Diagnosed Middle - Aged And Hypertensive Patients

Objective: Hypertension was a common and high-incidence clinical disease.It can easily cause endothelial function damage,including heart,head and blood-vessel.In order to prevent cardiovascular events early,it was important to assessment of vascular endothelial function in hypertension patients and determine its associated risk factors.The aim of this study was to investigate the relationship between vascular endothelial function and influencing factors,such as blood pressure variability,PWV,central blood pressure,biological factors,biochemical factors and behavioral factors,in the middle-age hypertensive patients at first diagnosis.Furthermore,we analyzed the clinical significance of these on vascular endothelial function to provide a reference for clinical treatment and prognosis evaluation of hypertension and related complications.Methods:(1)The inclusion criteria was that the hypertensive patients was middle-aged and was first diagnosed from January 2017 to January 2018.Initially,patients who were taking antihypertensive drugs regularly were excluded.All participants were selected from the outpatient department of Cardiology of Sichuan Provincial People's Hospital.(2)Patient information was collected by face-to-face questionnaire and clinical examination.The questionnaire included name,sex,age,height,weight,waist circumference,BMI,and living habits.(3)We had available information on patients' clinical characteristics at first diagnosis,including random value of peripheral blood pressure,fasting blood glucose,glycosylated hemoglobin,LDL-C,TG,TC,Protein A,s CRP,HCY,IMT,CASP,AIx,Pulse Wave velocity(PWV),urinary protein creatinine ratio,coefficient of variation of systolic blood pressure,coefficient of variation of diastolic blood pressure,systolic pressure of 24hours(24h SBP)Pressure(24h DBP),and blood flow-mediated endothelial function(FMD).(4)Data were cleaned by EXCEL.All analyses were conducted using SPSS22 software version.The strength was indicated by P value and P value <0.05 was considered statistically significant.Univariate analysis of biological factors,behavioral factors,biochemical factors,atherosclerosis indicators were performed:grouping the FMD line qualitative data chi-square test,the normal distribution data line independent sample F test,FMD value and the linear correlation between different factors Analysis,grouping FMD and various indicators of line logistics regression analysisResults:1.The number of men and women surveyed was not very different.The cohort was51.7% men and the mean age was 53±9 years old,which showed middle-aged patients had higher population in this cohort.2.Most of the participants were overweight or obese.Most of the participants were abdominal obesity.3.Most of participants(81%)were accustomed to sedentary and High-salt diet.4.The levels of fasting blood glucose,glycosylated hemoglobin,HDL-C,TC,CRP,HCY and Apo-A were in the normal range,while TG and urinary protein / creatinine had higher levels.5.The participants take the ambulatory blood pressure suggested that the average24-hour systolic blood pressure was an important influence of FMD.The result showed that 87.1% participants hypertension were mainly grade 1 level,The participants random noninvasive central artery systolic pressure was higher than peripheral blood pressure.6.The result showed that 16.4 % participants FMD less than 6%,was 19 person and83.6% participants FMD is normal.7.Most of participants combined the thickening of the carotid intima and atherosclerosis.CF and CR were higher than normal.The increased PWV and AIX response to a high degree of atherosclerosis in the middle-aged patients with hypertension.8.Single factor analysis showed that the effect of sedentary on vascular endothelium was obvious.Exercise can improve vascular endothelial function.Coefficient of systolic pressure variation had an obvious influence on vascular endothelial function than Diastolic coefficient of variation and 24-hour Average Blood Pressure.CF/CR and IMT were significantly related to FMD.PWV and IMT were indicator of damage to vascular endothelial.Patients with elevated PWV and carotid atherosclerosis and plaque formation should focus on vascular endothelial function protect early.9.After adding biological factors,biochemical factors,blood pressure,arteriosclerosis and other factors,multivariate analysis of grouped FMD the result showed that systolic blood pressure coefficient of variation and sedentary were excluded from the other factors was significantly correlated(P <0.05).Conclusion: Sedentary,obesity,TG,urine microalbumin,glycosylated hemoglobin were associated with the vascular endothelial function and might serve as risk factors of endothelial dysfunction in the middle-aged patients with hypertension.These data suggested that these patients should pay attention to the health life habits besides focused on the blood pressure.In addition,patients with elevated IMT,CF and CR should take endothelial function seriously to prevent cardiovascular events.