Lazúrová I, Pjescák M, Zábranská B, Trejbal D, Petrovicová J, Zemberová E, Kovácová A
II. interná klinika FNsP, Kosice.
Vnitr Lek. 1999 Sep;45(9):518-21.
The authors investigated the relationship between the activity of the renin-angiotensin-aldosterone system and serum lipid levels in patients with essential hypertension (EH). They examined 72 patients with EH stage I and II WHO classification (group A, n = 72, age bracket 16-70 years). They investigated the plasma renin activity (PRA), plasma aldosterone (PA) and total cholesterol (TCH), HDL, LDL cholesterol and triglycerides (TG). They divided the group into three sub-groups according to the PRA into low (L), normal (N) and high renin groups (H) In the whole group they did not find significant differences in the lipid levels in relation to PRA. They selected from the group patients older than 40 years (group B) and in those they recorded significantly higher TCH levels in group H as compared with normal (N) (p < 0.05) and L (p < 0.05) and significantly higher LDL levels in group H as compared with L (p < 0.01). They found a significant direct relationship between PRA and TCH (p < 0.05) and between PRA and LDL (p < 0.01), a liminal relationship between PA and TCH (p = 0.05). They did not find a significant relationship between the RAAS activity and HDL or TG. The authors conclude that patients with EH above 40 years and high PRA a markedly greater hyperlipoproteinaemia as compared with the low- or normal-renin group. This may partly explain the higher incidence of cardiovascular complications in high-renin EH reported by some authors.
作者研究了原发性高血压(EH)患者肾素 - 血管紧张素 - 醛固酮系统活性与血脂水平之间的关系。他们检查了72例世界卫生组织分类为I期和II期的EH患者(A组,n = 72,年龄在16 - 70岁之间)。他们检测了血浆肾素活性(PRA)、血浆醛固酮(PA)以及总胆固醇(TCH)、高密度脂蛋白(HDL)、低密度脂蛋白胆固醇和甘油三酯(TG)。根据PRA将该组患者分为三个亚组:低肾素组(L)、正常肾素组(N)和高肾素组(H)。在整个组中,他们未发现血脂水平与PRA之间存在显著差异。他们从该组中挑选出年龄大于40岁的患者(B组),发现H组的TCH水平显著高于正常肾素组(N)(p < 0.05)和低肾素组(L)(p < 0.05),且H组的低密度脂蛋白水平显著高于L组(p < 0.01)。他们发现PRA与TCH之间存在显著的正相关关系(p < 0.05)以及PRA与低密度脂蛋白之间存在显著的正相关关系(p < 0.01),PA与TCH之间存在临界关系(p = 0.05)。他们未发现肾素 - 血管紧张素 - 醛固酮系统活性与HDL或TG之间存在显著关系。作者得出结论,40岁以上且PRA高的EH患者与低肾素或正常肾素组相比,有明显更高的高脂蛋白血症。这可能部分解释了一些作者报道的高肾素型EH患者心血管并发症发生率较高的原因。