The Relationship Between Aldosterone/renin Ratio And Heart Rate Variability And QTc In Patients With Essential Hypertension

ObjectiveTo collect clinical cases to investigate the relationship between aldosterone(Ald)/renin(R)ratio and heart rate variability(HRV)and QTc in patients with essential hypertension(EH),and to predict patients with essential hypertension the risk of arrhythmia is present to guide medication.MethodRetrospective analysis of EH patients and normal patients who underwent 24-hour ambulatory blood pressure(ABPM)dynamic electrocardiogram(Holter)and electrocardiogram(ECG)examinations from December 2004 to February 2019,according to ambulatory blood pressure monitoring results and aldosterone The median/renin ratio(ARR)was divided into ARR high value group,ARR low value group,and hypertension ARR low value group(BP?140/90 mmHg,ARR?5.00),hypertension ARR there were 49 patients in the high value group(BP?140/90 mmHg,ARR>5.00)and 30 patients in the normal control group(BP?140/90mmHg).The data between the three groups were analyzed and the differences between the three groups were analyzed.Then,the differences between the groups were compared.The correlation and direction of ARR and heart rate variability index and QTc were analyzed by single factor pearson correlation.Finally,the factors that may be affected were controlled,and partial correlation analysis was applied.Further analysis of the correlation between ARR and heart rate variability indicators and QTc.ResultThere were 128 patients in the case group,including 79 males and 49 females,aged 30-75 years.There were 49 patients in the ARR high value group,49 in the ARR low value group,and 30 in the normal control group.There were no significant differences in age and biochemistry between the three groups.Age:(44.33±10.05)years old,(48.29±10.72)years old,(45.33±7.73)years old,gender(male): 39(49.4),23(29.1),17(21.5),BMI:(27.35±4.52),(25.41±3.06),(23.96±2.67),smoking: 15(57.7),7(26.9),4(15.4),TG(mmol/L):(1.76± 0.80),(1.82±0.94),(1.60±0.88),TC(mmol/L):(4.75±0.92),(4.86±1.01),(4.56±0.84),HDL-C(mmol/L):(2.97±0.73),(3.00±0.76),(1.35±0.33),LDL-C(mmol/L):(2.97±0.72),(3.00±0.76),(2.66±0.67),Glu(mmol/L):(6.39±3.10),(5.77±1.82),(5.63±0.79),heart rate variability index and QTc were significantly different(both P<0.05),QTc(ms):(394.63±39.19),(416.75± 34.55),(409.70±30.64),SDNN:(130.57±27.92),(107.94±22.65),(143.60±34.42),SDNN Index:(63.14±17.60),(53.22±16.74),(67.13±21.34),SDANN Index:(98.94±25.21,(81.06±17.37),(1 15.47±36.15),RMSSD:(69.88±46.74),(50.67±25.17),(71.73±46.23).QTc in high blood pressure ARR group was significantly higher than high blood pressure ARR low value group and normal control group [(416.75±34.55)The ratio was(394.63±39.19)ms,p<0.05].The high-density ARR high-value group was significantly lower than the high-pressure ARR low-value group and the normal control group[(107.94±22.65)ratio(130.57±27.92)and(143.60±).34.42),p<0.05],the SDNN Index of hypertension ARR high value group was significantly lower than that of hypertension ARR low value group and normal control group [(53.22±16.74)ratio(63.14±17.60)and(67.13±21.34),p< 0.05],the SDANN Index of high blood pressure ARR group was significantly lower than that of high blood pressure ARR group and normal control group [(81.06±17.37)ratio(98.94±25.21)and(115.47±36.15),p<0.05],hypertension The RMSSD of the ARR high value group was significantly lower than that of the high blood pressure ARR group and the normal control group [(50.67±25.17)ratio(69.88±46.74)and(71.73±46.23),p<0.05].Independent sample t-test showed that there was significant difference between high blood pressure ARR low value group and high blood pressure ARR high value group SDNN,SDNN Index,SDANN Index,RMSSD,QTc(P<0.05),high blood pressure ARR high value group and normal control group.There were significant differences between SDNN,SDNN Index,SDANN Index and RMSSD(P<0.05).There was no significant difference between low blood pressure group and normal control group.Pearson analysis showed that ARR was negatively correlated with SDNN,SDNN Index and RMSSD(r=-0.227,-0.208,-0.200,p<0.05).After applying partial correlation analysis to control other factors,ARR and SDNN,SDNN Index and RMSSD were stillanalyzed negative correlation.1.The ARR high value group has significantly reduced heart rate variability and QT interval prolongation compared with the ARR low value group and the normal control group.2.There was no significant difference in heart rate variability index and QTc between the ARR low value group and the normal control group.3.There was no correlation between ARR and QTc in this study.