| Background Coronary artery disease refers to a disease in which the coronary artery undergoes atherosclerotic changes that cause vascular stenosis or occlusion,resulting in myocardial ischemia and anoxic injury or necrosis.Hypertension is a cardiovascular syndrome characterized by elevated systemic arterial blood pressure.Hypertension and coronary heart disease have now become the two major diseases that harm human health.The common risk factors of coronary heart disease are family history,age,sex,smoking history,obesity,dyslipidemia,diabetes and so on.Hypertension is also one of the risk factors for coronary heart disease,and it is often associated with other pathogenic factors of coronary heart disease.However,at present there are few studies on the risk factors of hypertension combined with coronary heart disease.Further clinical studies are needed to explore the possible influencing factors on the disease of hypertension combined with coronary heart disease.Objective To investigate the risk factors for hypertension combined with coronary heart disease in order to provide more evidence for effective prevention or delay of hypertension complicated with coronary heart disease.Methods A total of 258 in-hospital hypertension patients from August 2015 to December 2016 were divided into hypertension group(124 cases)with average age(58.4±11.3 years)and hypertension combined with CHD group(134 cases)with average age(63.8±9.4 years),according to the results of coronary angiography and diagnostic criteria of coronary heart disease and hypertension.The age,sex,smoking history and drinking history of the subjects were recorded.The blood pressure values of the subjects were measured,and fasting blood glucose,platelet parameters,blood lipid levels and renal function indexes were detected.The differences of all indexes between the patients of two groups were compared,to determine the clinical and statistical significance of the parameters.Multivariate Logistic regression analysis was used to analyze the correlation between these indexes and CHD in hypertensive patients.Pearson correlation coefficient r was used to indicate the correlation between each index.Results(1)The values of age and smoking rate(63.8±9.4 years,32.1%)in hypertension combined with CHD group were higher than those(58.4±11.3 years,18.5%)in hypertension group patients,the differences were statistically significant(P<0.05).(2)Compared to hypertension group patients(13.94±2.68 fl,11.31±1.19 fl),the level of platelet distribution width and mean platelet volume(14.70±2.76 fl,11.74±1.13 fl)in hypertension combined with CHD group were higher(P<0.05).(3)The values of creatinine and uric acid(74.73±19.85μmol/L,361.16±76.23μmol/L)in hypertension combined with CHD group were higher than those(69.98±14.79μmol/L,319.22±80.48μmol/L)in hypertension group patients(P<0.05).(4)The HDL-C level(1.20±0.31mmol/L)was lower than that(1.35±0.37mmol/L)in hypertension group patients(P<0.05).(5)Multivariable logistic regression analysis demonstrated that age,smoking history,MPV,serum uric acid and low level of HDL-C [OR=1.062,95%CI:1.032～1.093;OR=2.048,95%CI:1.078～3.893;OR=2.737,95%CI:1.193～6.278;OR=1.006,95%CI:1.001～1.010;OR=0.280,95%CI:0.115～0.681(all,P<0.05)] were independent hazardous factors of CHD in hypertensive patients.(6)Pearson correlation analysis showed that: the mean platelet volume was positively correlated with uric acid(r=0.17,P<0.05).Conclusion The values of age,smoking ratio,platelet distribution width,mean platelet volume,creatinine and uric acid in patients of hypertension with coronary heart disease were higher than those in patients of hypertension group.Higher level of density lipoprotein cholesterol was a protective factor for CAD in hypertensive patients.The age,smoking history,MPV and serum uric acid were risk factors of CAD in hypertensive patients.Therefore,positive measures should be taken(quit smoking,regulating blood lipid level,control uric acid level,etc.)to reduce the risk of CHD in patients with hypertension. |
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