Study On Risk Factors Of HFrEF,HFmrEF Or HFpEF And Its Relationship With Peripheral Vascular Function In Patients With Hypertension

Objective: To explore the risk factors of different types of heart failure(HFrEF,HFmrEF,HFpEF)in patients with hypertension and their relationship with peripheral vascular function,and to provide reference for the diagnosis and treatment of different types of heart failure patients.Methods: Retrospective method,using "hypertension" and "heart failure" as search terms to retrieve medical records of patients with electronic medical record system of the First Affiliated Hospital of Guangxi Medical University,from October 1,2017 to October 1,2018 day.In this study,baPWV was tested using an atherosclerotic diagnostic medical device.The instrument model: BP-203 RPEII,which was produced by Japan Colin Medical Technology Corporation.Using SPSS 20.0 statistical software to compare and analyze baseline data of hypertension with different types of heart failure,24-hour ambulatory blood pressure,baPWV,cardiac ultrasound results.The relationship between hypertension and different types of heart failure and peripheral vascular disease was analyzed by logistic multivariate regression analysis.Results: According to strict inclusion and exclusion criteria,347 patients(154 males and 193 females)were eventually eligible for inclusion.Among them,241 patients with hypertension HFpEF group(EF≥50%,96 males and 145 females,including 38 patients with baPWV).54 patients with hypertension in the HFmrEF group(40%≤LVEF<50%,19 males and 35 females,of which 12 were tested for baPWV).There were 52 patients with hypertension in the HFrEF group(EF<40%,39 males and 13 females,of which 8 were tested for baPWV).Comparison of baseline data between the three groups of patients,In the HFpEF group,LDL-C,UA,and NT-proBNP were lower than the other two groups and women and wall motion segmental abnormalities accounted for a high proportion.Cardiac ultrasound comparison of three groups of patients:the left ventricular wall thickness of the HFpEF group was greater than that of the HFrEF group;the LVEDD of the HFpEF group was smaller than that of the HFrEF group,and the HFmrEF group was between the two.Analyze the comorbid conditions of the three groups of patients,HFrEF combined with the highest proportion of coronary heart disease;HFrEF and HFpEF showed that patients with atrial fibrillation and diabetes were more susceptible to HFpEF.Comparison of NYHA classification of cardiac function in three groups of patients,The HFpEF group had more grade III cardiac function.The comparison of peripheral vascular function in the three groups showed statistically significant differences in baPWV,SBP,and PP,and the HFpEF group was higher than the other two groups.Further logistic multivariate regression analysis,The results showed that women,hyperuricemia,diabetes,baPWV,SBP,pulse pressure were associated with hypertension and non-ejection fraction of heart failure.In other words,it is related to HFpEF and HFmrEF.Conclusions: 1.Hypertension combined with HFpEF group,the reduction of aortic elasticity and the increase of arterial wall stiffness were more obvious than hypertension HFrEF.2.Female,hyperuricemia,diabetes,increased pulse pressure,high SBP,and increased baPWV are independent risk factors for HFpEF in hypertension.