The Relationship Among Pulse Pressure,Carotid Intima-media Thickness And Pulse Wave Velocity In Hypertensive

ObjectiveTo investigate the relationship among pulse pressure,carotid intima-media thickness(cIMT)and carotid-femoral pulse wave velocity(cfPWV)in hypertensive.MethodsA retrospective analysis was carried out in 743 cases of hypertension patients and physical examination subjects in the outpatient department of the First Affiliated Hospital of Fujian Medical University during January 2016 to Jun 2017.The basic information of all subjects such as age,Medical history,history of smoking,the use of ACEI/ARB and statins,were recorded.The waist circumference,height,Weight of all subjects were measured and the body mass index were calculated.Blood glucose,blood lipid,renal function,liver function were measured by fasting venous blood sampling in the morning.Peripheral blood pressure and heart rate were measured by OMRON HEM-7052 electronic blood pressure meter and pulse pressure was calculated.The carotid-femoral pulse wave velocities(cfPWV)were measured by the automatic arteriosclerosis and cardiac function test system of Compaulay complementary Analyse.According to 2X2 design,all subjects were divided into hypertension group and normal blood pressure group.With cfPWV 10m/s as the cutting point,the two groups were further divided into two groups: the cfPWV increased group(cf PWV ? 10 m / s)and the cfPWV normal group(CF PWV < 10 m / s).Carotid intima-media thickness(cIMT)was measured by two-dimensional ultrasound.In addition,all subjects had divided into two groups by based on the cIMT at the cut-point of 1mm.all subjects were divided into the young and middle-aged group(<65 years old)and the elderly group(?65 years old)for stratification analysis by age at the cut-point of 65 years old.Correlation and multiple linear stepwise regression analysis were used to analyze the influencing factors of cfPWV.ResultsA total of 743 subjects were included in this study,including 274 non-hypertensive and 469 hypertensive.The cfPWV?PP?cIMT in hypertensive were significantly higher than that in non-hypertensive(P < 0.05).The cfPWV was divided into normal cfPWV group and high cfPWV group with 10m/s as the cutting point.The cfPWV in high cfPWV group was significantly higher than that in cfPWV normal group both in hypertensive and non-hypertensive.Subject were divided into middle and young age group(< 65 years old)and old age group(? 65 years old)according to age at the cut-point of 65 years old,The results showed that the cfPWV?PP?cIMT of the elderly was significantly higher than that of the middle and young people(P < 0.05),both in hypertensive and non-hypertensive.According to gender,there was no significant difference in PP and cIMT between male and female in hypertensive(P > 0.05),but the cfPWV in men was higher than that in females in non-hypertensive.After stratifying by cIMT at the cut-point of 1mm,the subjects with cIMT?1mm had higher cfPWV?PP than that with cIMT<1mm both in hypertensive and non-hypertensive.(P<0.05).It was showed that PP,cIMT,age,systolic blood pressure,diastolic blood pressure,heart rate,serum and fasting blood-glucose were correlated with cfPWV(r=0.527,0.335,0.493,0.521,0.186,0.122,0.222,P<0.05),while total cholesterol,high density lipoprotein,low density lipoprotein,glomerular filtration rate were negatively correlated with cfPWV(r=-0.137,-0.081,-0.098,-0.208,P <0.05).Multivariable linear regression analysis showed that PP,age,heart rate and gender were influencing factors for cfPWV both in hypertensive and non-hypertensive.Pulse pressure was the influencing factor of cfPWV regardless of sex ?age and hypertension stratification.cIMT was the influencing factor of cfPWV in middle and young people(<65 years),but not in old people(?65 years old).Conclusion1?Pulse pressure,carotid intima-media thickness,age is closely related to cfPWV.2?Pulse pressure,age,heart rate and gender were the influencing factors of cfPWV both in hypertensive and non-hypertensive.Pulse pressure was the influencing factor of cfPWV in elderly,middle-aged,male and female,while carotid intima-media thickness was only the influencing factor of cfPWV in middle-aged people,not cfPWV in the elderly,both in hypertensive and non-hypertensive.