Abstract:

Objective To investigate the value of noninvasive arterial stiffness indexes for predicting the risk of primary hypertensive patients with chronic kidney disease (CKD). Methods  A total of 541 patients with primary hypertensive were selected and 330 of them were simple primary hypertensive patients (hypertension group) and 211 of them were primary hypertensive patients with CKD (hypertension+CKD group). The carotid-femoral pulse wave velocity (cfPWV) and large and small artery elasticity indexes (C1 and C2) were measured by noninvasive test method of arterial stiffness. The pulse wave analysis (PWA) was performed and inter-media thickness (IMT) was measured by carotid ultrasonography. Results  Compared with the hypertension group, patients of the hypertension+CKD group were older, and had longer duration of hypertension, higher urine protein/creatinine ratio (P<0.01), and lower estimated glomerular filtration rate (eGFR) (P<0.05). After age, heart rate, duration, smoking, use of antihypertensive drugs, and brachial systolic blood pressure were adjusted, the cfPWV of the hypertension+CKD group was significantly higher than that of hypertension group (P<0.05). With the decrease of eGFR, cfPWV and IMT of two groups gradually increased (P<0.01) and C2 decreased (P<0.01). After cardiovascular risk factors were adjusted, cfPWV negatively correlated with the eGFR (r=-0.0851, P=0.02). Taken the primary hypertension combined with CKD as a binary categorical variable, multiple logistic analysis showed that the risk of CKD of patients with simple primary hypertension increased by 1.50 times with the increase of cfPWV by 1 SD (3 m/s). Conclusion  The cfPWV of primary hypertensive patients with CKD significantly increases, which can be used as a index for predicting the risk of CKD of primary hypertensive patients.

Key words: arterial stiffness, primary hypertension；chronic kidney disease, carotid-femoral pulse wave velocity； artery elasticity, inter-media thickness