Volume Status, Echocardiographic Findings, and Endothelial Functions in Primary Hypertension Patients Who Do Not Have Kidney Failure

Objective: Due to hypertension, the organs may get damaged over time, and with the damage of end-organ, the prognosis of the disease may get negatively affected. The intent of this study is to identify the contribution of hypervolemia to uncontrolled hypertension and how it affects endothelial function and echocardiographic findings in patients who have primary hypertension and who are not suffering from kidney failure.

Methods: This cross-sectional study was performed on patients who were going through a follow-up with a diagnosis of primary hypertension. The patient’s volume status was determined with the help of a body composition monitor. The patient’s ambulatory blood pressure was monitored for 24 h. Flow-mediated dilation (FMD), carotid intima-media thickness, and echocardiographic evaluation measurements were performed.

Results: The study included a total number of 101 patients out of which 63.4% of patients had an average blood pressure of less than 135/85 mmHg for 24 h, and 51% patients had non-dipper hypertension. The mean of hydration status value of patients was −0.25 ± 0.86 L, and 40.6% (n = 41) were identified as hypervolemic. The multiple logistic regression analysis of the factors for uncontrolled hypertension showed that the non-dipper and hypervolemic patients were 2.7 (1.1-6.5) times and 3.3 times, respectively, more likely to have greater mean blood pressure. Regarding mean FMD values and echocardiographic measurements, we failed to find any significant difference after observing both the uncontrolled and controlled hypertension groups. A positive correlation between carotid intima-media thickness and mean systolic arterial blood pressure was determined.

Conclusions: The significance of control of volume in terms of blood pressure control among patients with primary hypertension, who do not have a failure of the kidney, has been shown. However, this study could not establish the significance of volume control concerning endothelial and cardiac functions as opposed to patients who are suffering from kidney failure.

Cite this article as: Görkem H, Dizdar OS, Yeşiltepe A , Dondurmacı E, Özkan E, Günal İA. Volume status, echocardiographic findings, and endothelial functions in primary hypertension patients who do not have kidney failure. Turk J Nephrol. 2021; 30(3): 205-212.