Effects Of Intensive Blood Pressure Treatment And Folic Acid Supplementation On Bapwv In Patients With Type H Hypertension

Objectives:To investigate the effect of intensive blood pressure treatment and folic acid supplementation on Brachial-ankle pulse wave velocity(bapwv)in patients with type H hypertension in Xishan district,Kunming,and to guide the treatment of patients with type H hypertension.Methods:From August 2019 to August 2020,a total of 44 patients with diagnosed h-type hypertension were admitted to the out-patient department of Cardiology of Kunming First People’s Hospital,the patients were randomly divided into three groups:Intensive hypotension-folic acid group,Standard hypotension-folic acid group,standard hypotension group and intensive hypotension group.To investigate the effects of intensive antihypertensive therapy and folic acid supplementation on blood pressure and bapwv in patients with type H hypertension after 3 months.The primary outcome measure measures bapwv to assess arteriosclerosis.Baseline,blood Homocysteine(hcy),Total Cholesterol(TC),Low-density Lipoprotein(LDL)and High-density Lipoprotein(HDL)after 3 months were measured.Results:44 cases were followed up,11 cases in the intensive hypotension-folate group,12 cases in the standard hypotension-folate group,11 cases in the standard hypotension group,and 10 cases in the intensive hypotension group.The average age is 51.3.After 3 months,the mean systolic blood pressure was 119.7 mmHg(95%CI 111.11-128.29 mmHg),the mean systolic blood pressure was 134.3 mmHg(95%CI 131.43-137.17 mmHg)in the standard hypotensive group,121.14 mmHg(95%CI 111.84-130.44 mmHg)in the enhanced hypotensive-folic acid group,and 134 mmHg(95%CI 131.51-131.51 mmHg)in the standard hypotensive-folic acid group.During the course of treatment,1 case of postural hypotension and 1 case of stroke occurred.Pulse Wave Velocity(1588.6 ± 187.32 cm/s)was lower than the baseline value(1645.8± 194.75 cm/s),the pulse wave velocity(1620.4 ± 185.78 cm/s)in the standard hypotension group was also lower than the basal value(1669.5 ± 181.81 cm/s),and the pulse wave velocity(1696.9± 154.16 cm/s)in the standard hypotension-folate group was also lower than the basal value(1840 ± 134.55 cm/s),similarly,the pulse wave velocity(1679.6 ± 156.93 cm/s)of the patients in the enhanced hypotensive-folic acid group was also lower than the baseline(1799.7±150.08 cm/s),and there was a significant difference between the four groups(P<0.05),however,there was no statistically significant difference in the pulse wave conduction velocity after 3 months between the group of intensive blood pressure controlling therapy and standard blood pressure controlling therapy,the group of intensive blood pressure controlling therapy-folic acid supplementation and standard blood pressure controlling therapy-folic acid supplementation,the group of intensive blood pressure controlling therapy and intensive blood pressure controlling therapy-folic acid supplementation,the group of standard blood pressure controlling therapy and standard blood pressure controlling therapy-folic acid supplementation(p>0.05).Conclusions:In this study,both intensive and standard blood pressure controlling therapy decreased bapwv in patients with type H hypertension,but there was no significant difference between the two types;folic acid supplementation reduced serum homocysteine concentrations,however,the effect on the adjustment of bapwv in patients with type H hypertension was not obvious.