Relationship Between Plasma HCY And FMD,baPWV,ABI In Patients With Essential Hypertension

Objective: To investigate the correlation between plasma HCY and FMD,ba PWV,and ABI in EH patients,to verify the impairment of vascular endothelial function and elasticity by plasma HCY,to further improve the understanding of plasma HCY in patients,and to effectively treat the cardiovascular and cerebrovascular diseases Prevention.Methods: We select 251 cases of EH patients in the hypertensive area of the First Affiliated Hospital of Shanxi Medical University from 2016 to 2017.The patient's gender,age,height,weight,and DBP,SBP,heart rate,and Family history,Smoking history,drinking history and other general conditions measured at the time of admission were collected.According to the height and weight of the patient,the body mass index(BMI)was calculated using the formula body mass index(BMI)= weight/height 2.All patients had a short-term venous blood in the early morning of the next day,in order to subject-related blood biochemical tests.And professionals using the UNEX EF 38 G Vascular Endothelial Function Tester to measure blood flow-mediated vasodilation(FMD)and the use of Omron BP-203 RPE III arteriosclerosis detection device detection arm The brachial-ankle pulse wave velocity(ba PWV)(the highest value on both sides)and the ankle brachial index(ABI)(the lowest value on both sides)were measured.According to the FMD values,they were grouped into normal group(FMD>6%)and abnormal group(FMD<6%),and divided into normal group(ba PWV?1400cm/s)and abnormal group(PWV mean>1400 cm/s)according to ba PWV value.The normal distribution of measurement data using independent sample T test,classification data comparison using the chi-square test method for the patient's general data and Blood biochemical indicators were analyzed with FMD,ba PWV;Subjects were divided into four groups based on plasma HCY quartiles.Analysis of variance was used for trend testing among groups.According to the 2010 Chinese guidelines for hypertension prevention and treatment,the blood pressure of EH patients was graded.According to the blood pressure classification,the patients were divided into: hypertension level 1,hypertension level 2,and height The three groups of blood pressure were in three grades.The differences among HCY,FMD,ABI and ba PWV were compared among the three groups.The correlations between HCY and FMD,ba PWV,and ABI were analyzed using statistical methods of univariate,bivariate correlation,and multiple linear regression analysis,respectively.Results: 1.Single factor analysis of each factor and FMD showed that differences in age,smoking history,SBP,plasma HCY,BS,TC,HDL-C,LDL-C,Cystatin-C in normal and abnormal FMD groups.Then the differences has statistical significant(P<0.05).There was no significant difference in gender,BMI,drinking history,heart rate,DBP,TG,UA between the two groups(P>0.05).2.All factors were separately analyzed with ba PWV by single factor analysis.The results showed that the proportion of subjects with age,smoking history,SBP,hypertension grade,HCY,TC,TG,LDL-C,Cys-C in both the difference between the groups was statistically significant(P<0.05).Gender,drinking history,family history,DBP,heart rate,HDL-C,UA were not statistically significant between the two groups.3.FMD,ABI,ba PWV values for different plasma HCY levels: According to the quartile of plasma HCY EH patients were divided into: ?11.0(n=63),11.0 ? ? 14.2(n=63),14.2 ? ? 19.0(n=64),>19.0(n=61);FMD values in each group were:(6.78�2.04)%,(5.80�1.98)%,(5.17�2.26)%,(4.10�1.68)%;The effect of HCY levels onFMD in the four groups was statistically significant(F=19.46,P<0.001).The ba PWV values in each group were:(1526�255)cm/s,(1767�366)cm/s,(1925�278)cm/s,(2241�445)cm/s;the level of HCY between the four groups The impact on FMD in patients was statistically significant(F=47.3 P<0.001);the ABI values in each group were:(1.15�0.06),(1.12�0.07),(1.07�0.11),(1.02�0.12)There was a statistically significant difference in the effect of HCY levels on ABI between the four groups(F=21.30 P<0.001).Studies have shown that with the increase of plasma HCY levels,FMD,ABI showed a decreasing trend(P<0.05),ba PWV showed a trend(P<0.05).4.Plasma HCY levels in patients with different levels of hypertension: According to the 2010 Chinese guidelines for hypertension control,all EH patients were divided into 3 groups: hypertension level 1(n=70),hypertension level 2(n=90),and hypertension In level 3(n=91),the levels of plasma HCY in patients with EH were(11.71�3.97)umol/L,(15.80�7.56)umol/L,and(22.76�12.31)umol/L,respectively.With the increase of progression,plasma HCY showed an upward trend,and there was a statistically significant difference between the groups(P<0.05).5.Correlation analysis: The correlation analysis was performed using FMD as the dependent variable and the factors as independent variables.The results showed that: age,SBP,hypertension level,HCY,blood glucose,TC,HDL-C,LDL-C,Cys-C.There was a negative correlation between c and FMD(r =-0.491 P<0.001),(r =-0.240 P<0.001),(r =-0.601 P<0.001),(r =-0.523 P<0.001).(r =-0.256 P<0.001),(r =-0.224 P<0.001),(r =-0.135 P=0.032),(r =-0.158 P=0.012),(r =-0.311 P<0.001).Each factor was used as an independent variable and ba PWV was used as the dependent variable.Correlation analysis showed that age,SBP,hypertension grade,HCY,BS,TC,LDL-C,Cys-C and ba PWV were positively correlated.The correlation coefficients were:(r =0.452 P<0.001),(r =0.341 P<0.001),(r =0.654 P<0.001),(r =0.649 P<0.001),(r =0.275 P<0.001)(r =0.172 P= 0.006),(r =0.145 P=0.021),(r =0.264 P<0.001);taking each factor as an independent variable and ABI as the dependent variable for correlation analysis,the results showed that: age,SBP,hypertension level,HCY There was a negative correlation between blood glucose,TC,TG,LDL-C and Cys-C and ABI.The correlation coefficientswere:(r =-0.379 P<0.001),(r =-0.25 P<0.001),(r =-0.533 P<0.001),(r =-0.481 P<0.001),(r=-0.225 P<0.001)(r =-0.132 P=0.037),(r =-0.173 P=0.006),(r =0.262 P< 0.001).6.Multiple linear regression analysis:(1)multiple linear regression analysis of the factors associated with FMD,ABI,ba PWV,the results showed that: age,hypertension grading,plasma HCY,blood glucose,TC is the influencing factor of FMD;(2)Age,graded hypertension,plasma HCY,and blood glucose were the influencing factors of ba PWV;(3)Age,hypertension grading,plasma HCY,and blood glucose were also influencing factors of ABI.Conclusion: Plasma HCY in patients with essential hypertension is negatively correlated with FMD and ABI,and positively correlated with ba PWV.It is a predictor of endothelial dysfunction,hypoesthesia,and arteriosclerosis.Combining with hypertension can accelerate the occurrence and development of arteriosclerosis.