ASSA13-14-4 Hypertensive Early Renal Damage Aggravated the Arterial Endothelial Dysfunction in Hypertensive Patients with Carotid Plaques

Objective To explore the effects of hypertensive early renal damage on the arterial endothelial function in patients with hypertension and carotid plaques. Methods This cross-sectional study included 71 hypertensive patients with carotid plaques and 20 healthy people as normal control (NC group) aged 39 to 75 years. Seventy-one patients were divided into early renal damage group (RD group, n = 33) and no renal damage group (NRD group, n = 38) according to the level of the urinary albumin excretion rate (UAER). Early renal damage was defined as microalbuminuria which was a UAER > 30 and < 300 mg/24 hours. All patients underwent the following procedures: BP measurements, laboratory tests, the intima-media thickness (IMT) of common carotid artery and carotid plaques evaluation by ultrasonography, and endothelial function assessment by flow-mediated dilation (FMD) and Nitroglycerin-mediated dilation (NMD) in the brachial artery. Results (1) The UAER and fasting blood glucose (FBG) in the RD group was obviously higher than the NRD and NC group (P < 0.01). The systolic blood pressure (SBP), diastolic blood pressure (DBP), IMT and low density lipoprotein (LDL) in the RD and NRD group were higher than NC group (p < 0.01), but there was no difference between RD and NRD group. There was an increasing trend of the uric acid in NC, NRD and RD groups without statistical significance (p > 0.05). (2) The FMD% of patients with hypertension and carotid plaques was obviously lower than the NC group (P < 0.01) and the RD group was lower than the NRD group (P < 0.01). The NMD% of hypertensive patients with carotid plaques had the same trend as FMD%, but there was no significant difference between NRD and NC group.(3) The FMD% showed a negative correlation with SBP, total cholesterol, UAER IMT, LDL, and FBG (r = –0.329, –0.324, –0.512, respectively P < 0.01; r = –0.223, –0.223, –0.230, respectively, P < 0.01). The NMD% showed a negative correlation with the age, IMT and UAER (r = –0.227, –0.227,-0.231, respectively, P < 0.05). Conclusions Both endothelium-dependent and endothelium-independent vasodilatation are impaired in hypertensive patients with carotid plaques. Hypertensive early renal damage aggravated the arterial endothelial dysfunction.