Analysis Of Influencing Factors Of Arteriosclerosis In Young And Middle-aged Patients With Essential Hypertension

Objective: To explore the factors influencing the occurrence of arteriosclerosis in young and middle-aged patients with essential hypertension,this study explored the relationship between monocyte to HDL cholesterol ratio(MHR),hypersensitive Creactive protein(hs CRP),flow mediated dilation(FMD)and the occurrence of arteriosclerosis in young and middle-aged patients with essential hypertension.Methods:A total of 201 young and middle-aged patients with essential hypertension admitted to the Department of Cardiovascular Medicine of the First Affiliated Hospital of Anhui Medical University from From September 2020 to December 2022 were enrolled.General clinical data and laboratory results of all patients were collected on site.ba PWV and FMD were detected.According to ba PWV level,patients were divided into three groups: non-arteriosclerosis group(ba PWV<1 400 cm/s,n=47),mild arteriosclerosis group(ba PWV 1 400~<1 700 cm/s,n=106),moderate to severe atherosclerosis group(ba PWV 1 700~<2 000 cm/s,ba PWV≥2 000 cm/s,n=48).Body mass index(BMI),fasting blood glucose,blood lipid,FMD,MHR,hypersensitive Creactive protein(hs CRP),systolic blood pressure,diastolic blood pressure,monocyte count and other indexes were compared among all groups.Spearman’s method was used for correlation analysis.Multiple linear regression was used to analyze the relationship between MHR,hs CRP,FMD and ba PWV.Multivariate logistic regression was used to analyze the influencing factors of arteriosclerosis in young and middleaged patients with essential hypertension.Results:(1)The MHR of non-arteriosclerosis,mild arteriosclerosis and moderate to severe arteriosclerosis groups was 0.31(0.23-0.44),0.36(0.27-0.48)and 0.53(0.43-0.63)109/mmol,respectively,and the difference was statistically significant(H=34.041,P<0.05).The FMD of non-arteriosclerosis,mild arteriosclerosis and moderate to severe arteriosclerosis groups were(5.9±1.9)%,(4.8±1.6)% and(3.4±1.8)%,respectively,and the difference was statistically significant(F=26.552,P<0.05).The hs CRP of nonarteriosclerosis group,mild arteriosclerosis group and moderate to severe arteriosclerosis group were 1.01(0.70-1.98),1.19(0.89-1.89)and 2.12(1.78-3.15)mg/L,respectively,and the difference was statistically significant(H=45.019,P<0.01).(2)Spearman correlation analysis showed that there was a positive correlation between MHR,hs CRP and ba PWV(r=0.360,0.517,P<0.01),and a negative correlation between FMD and ba PWV(r=-0.462,P<0.01).(3)Spearman correlation analysis showed that MHR was positively correlated with hs CRP(ρ=0.402,P<0.01).(4)Spearman correlation analysis showed that MHR,hs CRP were negatively correlated with FMD(ρ=-0.252,-0.242,P<0.01).(5)Multiple linear regression analysis showed that after adjusting for confounding factors,FMD [B(95% CI)=-25.846(-38.346 ~-13.345)],hs CRP [B(95% CI)= 53.923(33.440 ~ 74.406)],MHR [B(95% CI)= 195.189(46.919 ~ 343.459)] were Independent influencing factors of ba PWV.(6)The results of multivariate logistic regression analysis showed that,MHR,FMD,age and systolic blood pressure were all independent factors influencing arteriosclerosis in essential hypertension [OR(95%CI)were 22.669(1.524~337.176),0.740(0.578~0.948),1.068(1.034~1.103)and 1.159(1.034~ 1.299),respectively,both P<0.05].Conclusion:In young and middle-aged patients with essential hypertension,MHR,hs CRP and FMD are closely related to the occurrence of arteriosclerosis,and are independent influencing factors of arteriosclerosis.