Florczak Elzbieta, Januszewicz Magdalena, Januszewicz Andrzej, Prejbisz Aleksander, Kaczmarska Magdalena, Michałowska Ilona, Kabat Marek, Rywik Tomasz, Rynkun Dariusz, Zieliński Tomasz, Kuśmierczyk-Droszcz Beata, Pregowska-Chwała Barbara, Kowalewski Grzegorz, Hoffman Piotr
Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
Blood Press. 2009;18(1-2):55-61. doi: 10.1080/08037050902864078.
The aim of our study was to evaluate renal resistive index (RI) value in never treated hypertensive patients in relation to ambulatory blood pressure measurement (ABPM) values and early target organ damage. The study included 318 subjects: 223 patients with never treated essential hypertension (mean age 37.1 years) and 95 normotensive healthy subjects (mean age 37.9 years). ABPM, echocardiography and carotid and renal arteries duplex color Doppler examinations were performed. RI values in patients with never treated essential hypertension were no different from the normotensive control group (0.59 +/- 0.05 vs 0.59 +/- 0.05; NS). In the untreated patients RI correlated significantly with 24-h pulse pressure (r=0.234; p<0.01) and ambulatory arterial stiffness index (AASI) values (r=0.274; p<0.001), intima-media thickness (IMT) (r=0.249; p<0.001), E'/A' (rho= -0.279; p<0.001) and relative wall thickness (RWT; r=0.185; p<0.01). In the multivariate stepwise analysis, RI values correlated independently with carotid IMT (beta=0.272; p=0.020) and 24-h AASI values (beta=0.305; p=0.009). In normotensive healthy controls, significant independent correlation between RI and carotid IMT and 24-h AASI values were also found. Our study may indicate limited value of RI in differentiating patients with uncomplicated hypertension with healthy controls. Renal resistive values were independently correlated with carotid IMT and AASI. These may suggest that renal vascular resistance is related to two markers for cardiovascular events both in the hypertensive and normotensive subjects.
我们研究的目的是评估未经治疗的高血压患者的肾阻力指数(RI)值与动态血压测量(ABPM)值及早期靶器官损害之间的关系。该研究纳入了318名受试者:223例未经治疗的原发性高血压患者(平均年龄37.1岁)和95名血压正常的健康受试者(平均年龄37.9岁)。进行了ABPM、超声心动图以及颈动脉和肾动脉双功彩色多普勒检查。未经治疗的原发性高血压患者的RI值与血压正常的对照组无差异(0.59±0.05对0.59±0.05;无显著性差异)。在未经治疗的患者中,RI与24小时脉压(r = 0.234;p < 0.01)、动态动脉僵硬度指数(AASI)值(r = 0.274;p < 0.001)、内膜中层厚度(IMT)(r = 0.249;p < 0.001)、E'/A'(ρ = -0.279;p < 0.001)以及相对壁厚度(RWT;r = 0.185;p < 0.01)显著相关。在多变量逐步分析中,RI值与颈动脉IMT(β = 0.272;p = 0.020)和24小时AASI值(β = 0.305;p = 0.009)独立相关。在血压正常的健康对照组中,也发现RI与颈动脉IMT和24小时AASI值之间存在显著的独立相关性。我们的研究可能表明RI在区分单纯性高血压患者与健康对照方面价值有限。肾阻力值与颈动脉IMT和AASI独立相关。这可能提示肾血管阻力在高血压和血压正常的受试者中均与心血管事件的两个标志物相关。