BLOOD PRESSURE PARAMETERS, CYS C AND MMP-9 LEVELS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND THEIR EFFECTS ON SEVERITY OF CORONARY LESIONS

Chunlei Yu*, Yanzhi Li, Yong Qiao, Xiaokai Liu, Renyun Wang

Department of Cardiovascular Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, China

Objective: This paper investigates the relationship between the dynamic blood pressure parameters and the severity of coronary lesions in patients suffering from essential hypertension. 

Methods: About 108 patients with essential hypertension who received cardiovascular care in our hospital from June 2017 to November 2018 were randomly divided into study groups. According to the number of coronary artery lesions in patients with coronary heart disease, they were divided into three groups: the single-vessel disease group (35 patients),  double-vessel disease group (36 patients) and the multi-vessel disease group (37 patients). At the same time, 40 healthy subjects who underwent physical examination at the same time were placed into the control group. Changes in dynamic blood pressure parameters (including 24h diastolic blood pressure, 24h systolic blood pressure, nocturnal systolic blood pressure, nocturnal diastolic blood pressure, daytime systolic blood pressure, daytime diastolic blood pressure, diurnal diastolic blood pressure and diurnal systolic blood pressure) and Cys C and MMP-9 levels were observed in all subjects. Changes in Gensini scores in patients with different severities of coronary artery disease were detected. The Pearson correlation test was used to analyse the correlation between the dynamic blood pressure parameters and the severity of coronary lesions in patients with essential hypertension. 

Results: Compared with the control group, the blood pressure parameters of the arteries in the study group were significantly higher (P<0.05 or P<0.01). The level of Cys C in the study group was significantly lower than that in the control group, and the level of MMP-9 was significantly higher than that in the control group (P<0.01). Compared with the single-vessel disease group, the 24h systolic blood pressure, nighttime diastolic blood pressure, nighttime systolic blood pressure, diurnal diastolic blood pressure and diurnal systolic blood pressure were significantly higher in the double-vessel disease group and the multi-vessel disease group (P<0.05 or P<0.01). The nighttime diastolic blood pressure and nighttime systolic blood pressure in the multi-vessel disease group were statistically significant compared with the double-vessel disease group (P<0.01). There was no significant difference in 24h diastolic blood pressure, daytime systolic blood pressure and daytime diastolic blood pressure between the groups (P>0.05). Compared with the single-vessel disease group, the Cys C level was significantly lower and the MMP-9 level was significantly higher in the double-vessel disease group and the multi-vessel disease group (P<0.01). As the disease progressed, the Gensini score increased significantly (P<0.01). According to the Pearson correlation test, the Gensini score increased significantly with the development of the disease. The dynamic blood pressure parameters and Cys C and MMP-9 levels of patients with essential hypertension showed different degrees of change. Diurnal diastolic pressure changes, diurnal systolic pressure changes, Cys C and Gensini scores were negatively correlated; however, 24h diastolic blood pressure, 24h systolic blood pressure, nocturnal diastolic blood pressure, nocturnal systolic blood pressure, daytime systolic blood pressure and diastolic blood pressure were positively correlated with Gensini score (P<0.05). 

Conclusion: The dynamic blood pressure parameters and MMP-9 levels of patients with essential hypertension are significantly higher than those in healthy subjects. The level of Cys C in such patients is significantly lower than in healthy subjects, and its level is related to the severity of coronary lesions.