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J Hypertens:原发性高血压患者血浆醛固酮浓度增加引起亚临床动脉粥样硬化

2019-06-17 xing.T MedSci原创

由此可见,该研究结果显示较高的PAC值与一些代谢变量密切相关,如甘油三酯、UAE、cIMT、更严重的ABI,颈动脉斑块以及血压升高,与动脉粥样硬化高风险和心血管并发症相关。

肾上腺皮质激素系统在​​心血管、代谢和肾损伤中起关键作用。近日,高血压领域权威杂志Journal of Hypertension上发表了一篇研究文章,该研究旨在评估原发性高血压患者血浆醛固酮浓度(PAC)与亚临床动脉粥样硬化一些替代指标之间的关系,如颈动脉内膜中层厚度(cIMT)、踝臂指数(ABI)和生化指标。 

从2014年1月至2017年12月,研究人员连续招募了804例原发性高血压患者(407名男性和397名女性,平均年龄为50±14岁),他们无心血管并发症,根据PAC四分位数对患者进行分组。

与PAC第一个四分位数相比,最高PAC四分位数与最高血清尿酸(SUA)(5.3±1.3 vs. 5.0±1.0mg/dl; P=0.01)、甘油三酯(117.5±15.7 vs. 106.8±10.5 mg/dl; P<0.05)、24小时尿白蛋白排泄(UAE)(38.8 vs. 7.6 mg/24h; P<0.05)、cIMT(0.87±0.22 vs. 0.80±0.21mm; P=0.001)和颈动脉斑块患病率增加(26 vs. 16%; P<0.005)相关。此外,研究人员发现在PAC超过150 pg/ml的患者中,ABI显著低于PAC<150 pg/ml的患者(1.01±0.09 vs. 1.10±0.09; P<0.022)。还发现PAC是原发性高血压个体中颈动脉斑块和病理性ABI(<0.9)的独立预测因子。 

由此可见,该研究结果显示较高的PAC值与一些代谢变量密切相关,如甘油三酯、UAE、cIMT、更严重的ABI,颈动脉斑块以及血压升高,与动脉粥样硬化高风险和心血管并发症相关。 

原始出处:

Concistrè, Antonio.et al.Subclinical atherosclerosis due to increase of plasma aldosterone concentrations in essential hypertensive individuals.Journal of Hypertension.2019.https://journals.lww.com/jhypertension/Abstract/publishahead/Subclinical_atherosclerosis_due_to_increase_of.97173.aspx

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2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050235, encodeId=347610502358b, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Mon Jun 17 17:23:00 CST 2019, time=2019-06-17, status=1, ipAttribution=)]
  5. 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  6. 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content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Wed Jun 19 05:23:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1544580, encodeId=134e15445801e, content=<a href='/topic/show?id=ac3d6549e75' target=_blank style='color:#2F92EE;'>#浓度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65497, encryptionId=ac3d6549e75, topicName=浓度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16b213663040, createdName=12498974m55暂无昵称, createdTime=Wed Jun 19 05:23:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050235, encodeId=347610502358b, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Mon Jun 17 17:23:00 CST 2019, time=2019-06-17, status=1, ipAttribution=)]
    2019-12-02 feather89
  7. 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content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Wed Jun 19 05:23:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1544580, encodeId=134e15445801e, content=<a href='/topic/show?id=ac3d6549e75' target=_blank style='color:#2F92EE;'>#浓度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65497, encryptionId=ac3d6549e75, topicName=浓度)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16b213663040, createdName=12498974m55暂无昵称, createdTime=Wed Jun 19 05:23:00 CST 2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050235, encodeId=347610502358b, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Mon Jun 17 17:23:00 CST 2019, time=2019-06-17, status=1, ipAttribution=)]
    2019-06-19 cmsvly
  8. 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  9. 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  10. 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2019, time=2019-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050235, encodeId=347610502358b, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Mon Jun 17 17:23:00 CST 2019, time=2019-06-17, status=1, ipAttribution=)]
    2019-06-17 jingjing

    大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等

    0

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怀孕前血压正常的孕妇在妊娠20周以后出现高血压、蛋白尿,称子痫前期,或称为先兆子痫。是妊娠期高血压疾病的五种状况之一,为妊娠期特发疾病,可影响机体各器官系统。发病率约占全部妊娠的3.9%。子痫前期的流行病学调查表明,该疾病具体遗传易感性的特征,但是子痫前期是否是原发性高血压潜在的遗传风险引起的结果还尚不明确有待调查。因为子痫前期的一个特征是高血压的情况。近期Smith CJ等人进行了一项研究探究高

SCI REP:比较原发性醛固酮增多症患者和原发性高血压患者微血管和大血管的变化!

总之,原发性醛固酮增多症患者相比于原发性高血压患者AVR发生了显著的改变,它可以代表微血管重塑的一个早期和更可靠的指标。

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