PRIMARY HYPERTENSION: RENAL VASCULAR DYSFUNCTION

Renal failure due to primary hypertension (HT) can be declined with precautions at early stages. In our study, glomerulo-tubular vascular function markers of 245 HT patients without end-organ damage have a mean age of 48±9 years, systolic blood pressure (SBP) 159±14, and diastolic blood pressure (DBP) 101+8 mmHg, were compared to 141 healthy individuals with a mean age of 46+9 and SBP, DBP 119+8, 78±5 mmHg respectively. According to control group, familial HT history, SBP, DBP (P<0.00001), body mass index (BMI, p<0.0001) and glucose (FBS, P<0.005) uric acid (UA, P<0.001) in serum, and daily urinary excretion of protein (UP, P<0.001), albumin (UAE), N-aceytl-D-glucosaminidase (NAG, p<0.00001), fi-2-microglobulin (film, P<0.005) were found to be elavated in HT group. A significant decline in serum Na+ was observed (P<0.05) in 110 patients whom SBP / DBP remained > 140 and/or 90 mmHg after a dietary salt restriction for one week. In BMI-II group (25-30 kg/m2 ) UA, UAE (P<0.001), NAG, film (P<0.005) levels were found to be higher than in BMII (<25 kg/m2 ) group. Positive correlations were found between hypertensive retinopathy (%59-HR) to patient's age, HT duration, SBP, DBP UA; and between smoking to UA, hemoglobin (Hb) and between FBG to BMI, serum Na+ in HT group. When compared to healtys', increased FBG (P<0.05) sCr (P<0.005) UA, UAE (P<0.0005), in hypertensive males and elevated Hb, fi2m (P<0.005), BMI, UP (P<0.0005), UA, UAE, NAG (P<0.00005) in hypertensive females were found. Our findings suggest that renal vascular dysfunctions were occurred at early stages in HT, males have tendency to systemic, females to renal vascular damages are increased with obesity, smoking, salt.