THE RELATIONSHIP BETWEEN HCY LEVEL AND HEART, KIDNEY AND CAROTID ARTERY INJURY IN YOUNG PATIENTS WITH ESSENTIAL HYPERTENSION

Wencheng Xu^*, Yukai Chen, Fan Jiang, Shishi Zhong, Suqiang Shen

Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, PR China

Purpose: The purpose of this study was to analyse the relationship between homocysteine (Hcy) levels and left ventricular mass index, renal injury and carotid intima-media thickness (CIMT) in young patients with essential hypertension. 

Method: From November 2018 to June 2019, 90 young patients admitted to the Cardiology Department at our hospital with primary hypertension were divided into groups according to the classification of their hypertension (the first-level group, the second-level group and the third-level group). Meanwhile, healthy people at our hospital were selected as the control group. The correlation between Hcy level and left ventricular mass index (LVMI), renal injury and carotid artery CIMT was analysed. 

Results: The levels of diastolic blood pressure (DBP) and systolic blood pressure (SBP) of the patients in the three hypertension groups were higher than those of the patients in the control group, and the levels of DBP and SBP of the patients in the second- and third-grade hypertension groups were higher than those of the patients in the first-grade hypertension group (P<0.01). The Hcy levels in the patients in the three hypertension groups were higher than those in the patients in the control group; the Hcy levels in the patients in the second- and third-grade hypertension groups were higher than those in the patients in the first-grade hypertension group, and the Hcy levels in the patients in the third-grade hypertension group were higher than those in the patients in the second-grade hypertension group (P<0.05). The E/A ratios of the patients in the first-grade hypertension group were significantly lower than those of the patients in the control group (P<0.05), but there was no significant difference between the groups in terms of LVMI, left anterior descending artery (LAD), relative wall thickness (RWT), left ventricular mass (LVM) or CIMT (P>0.05). LVMI, LAD, RWT, LVM and CIMT were significantly higher and E/A was significantly lower in patients in the second-grade hypertension, third-grade hypertension and control groups (P<0.05). LVMI, LVM, LAD and CIMT were significantly higher in patients in the third- and second-grade hypertension groups (P<0.05), while RWT and E/A ratios were not significantly different (P>0.05). There was no significant difference between any of the groups in terms of left ventricular ejection fraction (LVEF) (P>0.05). Compared with the renal function indexes of patients in the control group, the renal function indexes of patients in the first-grade hypertension group exhibited no significant increase (P>0.05), but the renal function indexes of patients in the second-grade hypertension and the third-grade hypertension groups were significantly increased (P<0.05 or 0.01), and the renal function indexes of the patients in the third-grade hypertension group were higher than those of the patients in the second-grade hypertension group. Compared with the patients in the control group, the patients in all three hypertension groups exhibited a significantly decreased glomerular filtration rate (GFR) (P<0.01). Hcy levels were found to be positively correlated with LVMI, CIMT, DBP and SBP in the young patients with essential hypertension. Meanwhile, Hcy levels were found to be negatively correlated with GFR and positively correlated with cystatin C (Cys C) and urine microalbumin and urine creatinine (UmAlb/Cr) in the young patients with essential hypertension. 

Conclusion: Hcy levels are closely related to the degree of injury of the heart, kidney and carotid artery. The more serious the injury is, the higher the concentration of Hcy is. Thus, Hcy can be used as an important indicator of the prognoses of young patients with essential hypertension and can be used in the prevention and treatment of essential hypertension in young patients.