| Objective: With the people’s living standard enhancement, had different degrees of change of life style and dietary levels, the incidence rate of cardiovascular disease is increasing year by year, and has become one of the diseases with the highest mortality rate of population in china. In all cardiovascular disease, coronary heart disease(Coronary heart disease, CHD) coronary atherosclerotic heart disease, is the outpatient and inpatient patients of common diseases and frequently occurring disease, is also the main pathogenic, disability or even death cause. The harm to human beings gradually attracted people’s attention. Therefore, the risk factors of coronary heart disease and effective control of the blood glucose, blood lipids, hypertension, including metabolic disorder has a very positive meaning. In recent years, with the progress of medical knowledge popularization and the coronary heart disease diagnosis and treatment technology, the overall mortality in patients with coronary heart disease rate is decreased. The study found that, coronary heart disease has a higher rate of recurrence and rehospitalization rate, and atypical symptoms. Coronary heart disease prevalence factors of International reported so far has 300 a variety of, find the susceptible factors of prevention of coronary heart disease for some more traditional risk factors, such as age, obesity, smoking, drinking, hypertension, diabetes, dyslipidemia, for people in certain risk factors has not been enough attention, and the need to further explore. The blood homocysteine(homocysteine, Hcy) 2- amino- 4 hydrophobic butyric acid, is a product of methionine metabolism in the body, it is a new risk factor for cardiovascular disease. Studies have shown that with high homocysteine levels, the primary hypertension(H hypertension) [1], the risk of stroke and the risk of ischemic heart disease were significantly increased [2]. There are related articles reported H high blood pressure is the independent risk factors of stroke [1], [3] [4]. And about H the relationship between hypertension and coronary heart disease(CHD) in dispute, this article preliminarily H hypertension and coronary heart disease and coronary artery lesion degree of relationship.Methods: 1 From October 2013 to October 2013 during a division in the hospital within your heart and accept PHILIPS FD20 instrument type digital subtraction angiography coronary angiography examination(coronary angiography the CAG) of 357 cases of patients, according to the results of coronary angiography were divided into CHD group and non CHD group, 1-2 days after admission to extract all the subjects on an empty stomach venous blood plasma homocysteine levels, the measure of the statistical analysis. At the same time record the patients’ blood pressure, blood sugar, blood lipid and collect patients were gender, age, and past medical history. According to the baseline plasma Hcy levels and blood pressure levels in patients with coronary heart disease can be divided into four subgroups: pure hypertension group(SBP 140 MMHG or higher and/or DBP 90 MMHG or higher); Pure high Hcy group(Hcy 10 mu mol/L or higher), H hypertension(hypertension combined high Hcy), Both of the normal group. Statistical processing applications SPSS20.0 statistical software, the single factor using t- test,- test, multi-factor analysis USES the unconditioned logistic regression analysis. 2. According to the clinical manifestations of coronary heart disease can be divided into stable angina pectoris(SAP), unstable angina pectoris(UAP), myocardial infarction(AMI) three type, comparison between groups of Gensini score, Hcy levels and H patients with high blood pressure. 3. The multi-factor Logistic regression analysis revealed that the independent risk factors for coronary heart disease(CHD) for H high blood pressure.Results:(1) the homocysteine levels in patients with coronary heart disease group(15.04 + 7.80 u mol/L) is higher than the 10.84 + 6.01 u mol/L) for CHD group, differences were statistically significant(P < 0.01).(2) H hypertension subgroup number accounts for 41.4% of the number of coronary heart disease(CHD), higher than the pure high Hcy subgroup number 30.2% of the ratio of the number of coronary heart disease(= 69.60, P < 0.01); Also higher than that of pure hypertension subgroup number account for 23.3% of the ratio of the number of coronary heart disease(X2 = 58.99, P < 0.01); Higher than normal subgroups in 5.1% rate of acute coronary heart disease(= 34.70, P < 0.01), four groups have significant difference.(3) Hcy levels and severity of coronary artery disease, coronary heart disease can be divided into stable angina, unstable angina and myocardial infarction model, analysis of variance results shown: the average level of Hcy in patients with stable angina(13.92 + 7.20 u mol/L); Average Hcy levels for patients with unstable angina(14.38 + 8.09 u mol/L); Average level of Hcy in myocardial infarction(23.13 + 5.42 u mol/L), between data comparison, Hcy levels in patients with AMI group were higher than UAP group and SAP group, with significant difference(P < 0.05), the UAP group Hcy levels there was no statistically significant difference compared with the SAP group(P > 0.05), in patients with CHD, SAP group and UAP group, AMI group H hypertension prevalence rate were 32.82%, 45.90%, 78.26%, the comparison between 3 group were statistically significant(P < 0.05).(4). Hcy and coronary artery Gensini score correlation analysis showed that plasma Hcy levels and coronary artery lesions was a positive correlation between Gensini score. 6. The multi-factor Logistic regression analysis revealed that the independent risk factors for coronary heart disease(CHD) for H hypertension(Wald = 8.669).Conclusions:1 Heart disease patients with plasma homocysteine levels higher than non patients with coronary heart disease.2 H type hypertension can predict coronary heart disease coronary artery disease.3 In ruling out other risk factors, H type hypertension were independent risk factors of coronary heart disease. |
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