Analysis of the correlation of hemodynamic changes in the renal artery with the ambulatory arterial stiffness index and pulse pressure in middle-aged and elderly hypertension patients
10.3760/cma.j.issn.0254-9026.2023.12.013
- VernacularTitle:中老年高血压患者肾内动脉血流动力学变化与动态动脉硬化指数和脉压的相关性分析
- Author:
Yuanyuan GAO
1
;
Shuo LI
;
Shifang ZHU
;
Jing YE
;
Xiaojuan WANG
Author Information
1. 首都医科大学附属北京朝阳医院综合科,北京 100020
- Keywords:
Vascular resistance;
Hypertension;
Arterial resistive index;
Ambulatory arterial stiffness index
- From:
Chinese Journal of Geriatrics
2023;42(12):1464-1467
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the extent of hypertensive renal vascular damage by analyzing the correlation of the renal artery resistive index(RI)with the ambulatory arterial stiffness index(AASI)and pulse pressure.Methods:A retrospective case-control study was conducted enrolling 1 226 hypertension patients from the General Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University between May 2018 and May 2023, and the hemodynamics of the renal artery were examined, with 187 patients showing abnormal blood flow, of whom, 78 were in the group with renal artery stenosis and 109 were in the group without renal artery stenosis, and 1, 039 had normal renal arterial blood flow(the control group). AASI and pulse pressure values were compared between hypertension patients with different degrees of increased resistance to renal blood flow; Spearman's rank correlation analysis was conducted to assess the correlation of AASI and pulse pressure with the degree of renal injury in elderly hypertension patients; The receiver operating characteristic(ROC)curves were plotted for hypertension patients with renal hemodynamic abnormalities based on the existence of renal artery stenosis and the results of RI, AASI and pulse pressure.Results:Patients in the renal artery stenosis, no renal artery stenosis, and control groups had statistically significant differences in RI[(0.83±0.05), (0.78±0.02), (0.71±0.03), F=410.44, P<0.01], AASI[(0.61±0.05), (0.58±0.06), (0.37±0.05), F=734.77, P<0.01], and pulse pressure[(1.71±0.15), (1.44±0.22), (0.88±0.25), F=968.99, P<0.01]; Compared with the group with no renal artery stenosis and the control group, the renal artery stenosis group also showed statistically significant differences in values of the three parameters( F=66.34, 9.87 and 160.51, respectively, P<0.05 for all). Pearson correlation analysis showed that RI was positively correlated with AASI and pulse pressure( r=0.730 and 0.762, respectively, P<0.01 for both). The cut-off value was 0.77 for RI, 0.52 for AASI and 1.31 for pulse pressure for renal artery stenosis in elderly hypertension patients, and the areas under the curve were 0.897, 0.830 and 0.951, respectively( P<0.05 for all); The sensitivities were 87%, 95% and 98% and the specificities were 68%, 67% and 71%, respectively. Conclusions:RI, AASI, and pulse pressure can effectively predict renal artery damage in middle-aged and elderly hypertension patients.