| Objective:To investigate the carotid atherosclerosis risk factors of H-type hypertension.Methodology:A total of 240 patients with essential hypertension who were admitted to the 515th LA hospital from january 2017 to january 2018 were selected.According to the plasma homocysteine(Hcy)level,participators were divided into H-group(plasma Hey>10μmol/L)with 118 cases and simple group(plasma Hcy<10μmol/L)with 122 cases.Recorded patients’age,exy ratio,height,weight,smoking history,duration of hypertension,blood pressure;blood lipids,blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),the carotid intima-media thickness,carotid atherosclerotic plaques and the condition of carotid stenosis.Compared the collected indicators between the two groups and analyzed the risk factors of carotid atherosclerosis in patients with H-type hypertension.Result:1.Male composition(55.1%),coronary heart disease(CHD)history(20cases),stroke history(25cases),mean systolic blood pressure(SBP)(145.57±18.29mmHg)and pulse pressure(PP)(62.27±8.39 mmHg)in H group were significant different with male composition(41.0%),CHD history(9cases),stroke history(13cases),mean SBP(136.32±17.62mmHg)and PP(62.27±8.39mmHg)in simple group(P<0.05).However,there was no significant difference in age composition,body mass index,smoking history,diabetes history,diastolic blood pressure(DBP)and hypertension(P>0.05).2.Plasma Hey(21.26±7.90μmol/L),LDL-c(2.87±0.50mmol/L),BUN(6.54±1.67μmol/L),Cr(90.35±23.80mmol/L)and UA(344.47±99.15μmol/L)levels in patients with H-type hypertension were significantly higher than Hey(7.17±1.86μmol/L),LDL-c(2.43±0.30mmol/L),BUN(6.54±1.67μmol/L),Cr(72.39±19.13mmol/L)and UA(318±94.35μmol/L)levels of simple group(P<0.05).There was no significant difference in TG and TC between the two groups(P>0.05).3.The detection rate of the carotid intima-media thickening(IMT)(75.4%),plaque formation(38.1%),IMT(0.91±0.23mm),the plaque number>3(11.9%),carotid stenosis>50%(8.5%)in H group patients were much more serious than detection rate of IMT(39.3%),plaque formation(12.3%),IMT(0.77±0.18mm),the plaque number≥3(3.3%),carotid stenosis>50%(1.6%)of simple group(P<0.01).4.The detection rate of the carotid IMT(93.4%),plaque formation(50.8%),IMT(1.00±0.20mm),the plaque number>3(19.7%)and the carotid stenosis>50%(14.8%)in the H-type hypertension patients aged>60 were significantly higher than those in patients aged<60(P<0.05).In contrast of female patients with H-type hypertension,the detection rate of plaque formation(75.4%)and plaque number≥3(47.7%),carotid stenosis>50%(13.8%)were higher in male patients(P<0.05).The detection rate of the carotid IMT(95.0%),plaque formation(52.5%),carotid stenosis>50%(20%),IMT(1.02±0.23mm),the plaque number≥3(25.0%)were significantly higher in smokers with h-type hypertension than in non-smokers(P<0.05).In H-type hypertension patients whos were overweight,the detection rate of the carotid IMT(84.6%),plaque formation(47.7%),carotid stenosis>50%(13.8%),IMT(0.97±0.24mm),the plaque number≥3 were significantly higher than those with normal weight(P<0.05).IMT(0.98±0.26mm),plaque number≥3(20.4%)in H-type hypertension patients with high TG were higher than those of normal group(P<0.05).The detection rate of the carotid IMT(89.5%),IMT(1.03±0.26)mm,plaque number>3(33.3%)in H-type hypertension patients with high LDL-C were higher than those of normal group(P<0.05).IMT(1.03±0.26)mm,plaque formation(60.9%)in H-type hypertension patients with high HDL-C were higher than those of normal group(P<0.05).The detection rate of the carotid IMT(100%),IMT(1.07±0.26)mm,plaque number>3(33.3%)in H-type hypertension patients with high UA were higher than those of normal group(P<0.05).5.Multivariate Logistic regression analysis demonstrated that aged,smoking history,high LDL were significantly associated with carotid intima-media thickening in H-type hypertension patients,with OR values respectively1.282(95%CI:1.133-1.451),6.663(95%CI:1.200-20.669),4.301(95%CI:1.199-15.434).Moreover,aged,overweight,high LDL with OR values 1.150(95%CI:1.069-1.238),3.496(95%CI:1.353-9.033),1.244(95%CI:1.014-1.526)were significantly associated with plaque formation.Conclusion:1.There were a greater proportion of male and a significant increase in systolic pressure and pulse pressure in H-type hypertension patients,with higher risks of complications included cardiovascular diseases,stroke,renal dysfunction,lipid metabolism disorder,hyperuricemia.2.The detection rate of the carotid intima-media thickening,plaque formation,carotid stenosis>50%in H-type hypertension patients were more serious than those in simple hypertension patients.3.Aged,smoking history,high LDL were significantly associated with carotid intima-media thickening of H-type hypertension patients.Aged,overweight,high LDL were significantly effect on the progression of plaque formation. |
PDF Full Text Request