| Hypertension is a complex disease whose cause is not yet clear.According to reports,the number of hypertensive patients worldwide has reached 1.56 billion.Hypertension has brought a heavy disease burden to all human beings.It has become a major global public health problem.Conventional biochemical indicators such as heart,liver,kidney and blood can be used as auxiliary indicators for hypertension prediction.The first part of this study explores the association of clinical biochemical indexes with the risk of hypertension.Oxidative stress may be related to the pathogenesis of hypertension.It is unclear whether higher levels of oxidative stress in the body are associated with increased risk of hypertension.The second part of this study explores the association of oxidative stress biomarker with the risk of hypertension.Part Ⅰ Association of clinical biochemical indexes with the risk of hypertensionObjective: This study aimed to investigate the potential association of clinical biochemical indexes with the risk of hypertension and blood pressure.Methods: This study was conducted from July 2015 to June 2018.Hypertensive patients are collected in the Department of Cardiology of a general hospital in Wuhan and healthy people with normal blood pressure are recruited in Physical Examination Center at the hospital.A case-control study design was used.Epidemiological and biochemical data of the subjects were obtained through questionnaires and medical records.This study analyzed 16 clinical biochemical indexes and compared the differences of biochemical indexes in hypertensive patients with healthy controls.Logistic regression models were used to analyze the association of biochemical indexes with the risk of hypertension.The linear regression models were used to analyze the correlation between biochemical indexes with blood pressure.Results: On the basis of the first part of the study,hypertensive patients with insufficient urine samples to detect oxidative stress marker were excluded.896 cases of hypertension were included,and 983 healthy controls who were matched to cases by gender and age.Among the male participants,hypertensive patients had higher levels of white blood cell(WBC)counts,gamma-glutamyl transpeptidase(GGT),alanine aminotransferase(ALT),blood glucose(Glucose,Glu),creatinine(Cre),uric acid(UA)and lower levels of total protein(TP),albumin(ALB),globulin(GLB),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)(P<0.05).Among female participants,hypertensive patients have higher levels of WBC counts,GGT,ALT,Glu,triglyceride(TG),Cre,UA and lower levels of TP,ALB,GLB,TC,HDL-C,LDL-C(P<0.05).Logistic regression analysis of biochemical indexes with the risk of hypertension showed,the levels of WBC counts,TP,ALB,Glu,TC,and UA were significantly associated with the risk of hypertension among male participants(P<0.05),among them,WBC count,Glu and UA are positively correlated with the risk of hypertension.Among female participants,the levels of WBC counts,TP,Glu,TC,TG,Cre were significantly associated with the risk of hypertension(P<0.05),among them,WBC counts,Glu,TG and Cre are positively correlated with the risk of hypertension.Linear regression analysis of biochemical indexes with blood pressure showed that Glu and UA were positively associated with systolic blood pressure and diastolic blood pressure in male participants(P<0.05).TG was found positively associated with systolic blood pressure and diastolic blood pressure in female participants(P<0.05).Conclusions: Higher levels of WBC counts,Glu,TG,Cre,and UA may be associated with increased risk of hypertension,and higher levels of Glu,TG,and UA may be associated with higher systolic and diastolic blood pressure,and there may be gender differences in these associations.Part Ⅱ Association of oxidative stress biomarker with the risk of hypertensionObjective: This study aimed to evaluate the association of oxidative stress biomarker with the risk of hypertension and blood pressure values in Chinese Han population by using urine samples as a biological sample matrix.Methods: The participants’ recruitment of this research is the same as that of the first part.Analysis was performed using a case-control design.Urine were used as the matrix for biological samples.The concentrations of malondialdehyde(MDA),biomarker of oxidative stress in urine samples,were measured using ultraviolet-visible spectrophotometer.Dose-response analyses of MDA concentrations with the risk of hypertension and blood pressure values were performed using restricted cubic spline(RCS)models.Logistic regression models were used to analyze the association of MDA with the risk of hypertension.The association of MDA concentrations in urine with blood pressure values were analyzed by multiple linear regression models.Results: A total of 1792 subjects were enrolled in the study,including 896 hypertensive cases,and 896 healthy controls who were matched to cases by gender and age.The results showed that MDA concentrations in the urine of hypertensive patients were higher than those of healthy controls,and the differences were statistically significant(P<0.05).The results of the RCS models illustrated that the risk of hypertension and blood pressure values were increased with the increase of MDA concentrations in urine after adjustment for confounding factors,displaying a monotonous upward trend.Logistic regression models showed that a significant association between MDA concentration and the risk of hypertension was found in the general population and male participants(P<0.05),and a suggestive association was found among female participants after adjusting confounders(P=0.075).For each increased unit of MDA concentration in the urine,the risk of hypertension increased by 16.2%(95%CI:1.09,1.24)、26.3%(95%CI:1.15,1.40)and 6.3%(95%CI:0.99,1.15)in the total population,male and female participants,respectively.In addition,the linear regression models showed that the quartile of MDA concentrations in urine had a dose-response relationship with systolic blood pressure in the general population and male participants(P for trend<0.05).In general population and male participants,individuals in the highest quartile of MDA were found to have a 2.49(95% CI: 0.17,4.80)and 3.67(95% CI: 0.85,6.49)mmHg higher level of systolic blood pressure,respectively.Hierarchical analysis results displayed that the association of urinary MDA concentration with the risk of hypertension was more pronounced in subgroups of people over 55 years old,obesity,smoking,lower income,and lower education.Compared with patients without using any antihypertensive drugs,patients with calcium channel blocker(CCB)antihypertensive drugs had significantly lower MDA concentrations in the urine(P<0.05).Conclusions: Higher MDA concentrations in the body may be associated with increased risk of hypertension,and higher MDA concentrations in the body may be associated with higher systolic blood pressure,and there may be gender differences in these associations. |
