Association of increased arterial stiffness and inflammation with proteinuria and left ventricular hypertrophy in non-diabetic hypertensive patients.
OBJECTIVE
Both arterial stiffness and proteinuria are important markers for organ damage in hypertension. This study was planed to investigate the association between arterial stiffness and inflammation and to define the influences of proteinuria on arterial stiffness and inflammation in non-diabetic hypertension.


METHODS
We enrolled 205 patients (mean age 41 +/- 8 years, 66 women) with essential hypertension noted for less than 5 years in this study. They did not have diabetes mellitus or any overt cardiac, vascular, or renal complications. Stiffness index (SI) derived from digital volume pulse was used for assessment of arterial stiffness. High-sensitivity C-reactive protein (hsCRP) was measured in each patient during enrollment. Left ventricular hypertrophy (LVH) was documented by electrocardiography and proteinuria was assessed by measuring 24-h urine protein.


RESULTS
SI was significantly correlated with hsCRP (r = 0.166, p = 0.017). LVH was noted in 34 patients (17%). SI was significantly higher in patients with LVH (8.03 +/- 1.74 vs 7.19 +/- 1.19 m/s, p = 0.001). Proteinuria was noted in three patients with LVH. SI was gradually increased among patients without LVH, with LVH but not proteinuria, and with LVH and proteinuria (7.19 +/- 1.19, 7.68 +/- 1.21, 11.75 +/- 2.51 m/s respectively; p<0.001). HsCRP was also gradually increased among patients without LVH, with LVH but not proteinuria, and with LVH and proteinuria (0.20 +/- 0.24, 0.30 +/- 0.59, 1.56 +/- 1.58 mg/dl respectively; p<0.001).


CONCLUSIONS
SI was significantly correlated with hsCRP. Arterial stiffness and inflammation were increased in association with proteinuria in non-diabetic essential hypertension.
Tsai
Wei-Chuan
WC
Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Dou-Liou, Taiwan. wctsai@ksmail.seed.net.tw
Lin
Chih-Chan
CC
Huang
Yao-Yi
YY
Chen
Ju-Yi
JY
Chen
Jyh-Hong
JH
D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D007249:Inflammation / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010992:Plethysmography, Impedance; D011507:Proteinuria / Q000150:complications* / Q000652:urine; D011673:Pulsatile Flow
D002097:C-Reactive Protein