Utility Of Valuable Arterial Stiffness Par Ameters In Patients With Coronary Heart Disease And Hypertension

Objectives:In aging societies, most attention is focused on the relation between arterial stiffness and coronary vascular disease. Although traditional risk factors have been familiar to the people, simpler, noninvasive, and more economical methods are needed to evaluate progress. With the development of science and technology, people have started to pay more attention to evaluate degrees of arterial stiffness with noninvasive methods. The biggest advantage of these methods is that they can be used in large populations, so people with risk factors can be found early and effective methods can be adopted to prevent further progress, therefore, it is imperative to select new indices and evaluate their effect on the progress of coronary vascular disease. Some researches abroad have been completed on evaluating these indices on coronary heart disease, hypertension, chronic kidney disease, diabetes mellitus and hyperglycemia. However, the amount of domestic research is far less. The aim of this research is to study some indices among the patients with CHD and related risk factors using newest equipment available. These indices included: brachial-ankle pulse wave velocity (baPWV), ankle branchial index (ABI), central systolic blood pressure (CSBP), and radial augmentation index (rAI). Our goal is to compare the difference between normal people and patients, and thus predict the effect of these indices on future progress.Content:1. Compared the difference of baPWV between the patients with CHD and patients without CHD, and evaluated its influencing factors.2. Analyzed the relationship between low ABI and re-hospitalization within one year in CHD patients with ischemic heart disease or shock.3. Studied the differences in rAI between male and female patients without CAD and its influential factors; to assess the differences of peripheral and central pulse wave in men with and without CAD and the influential factors of rAI.4. Compared the different degree of peripheral BP and CSBP in regression of LVH, and evaluated the effect of CSBP on antihypertensive therapy.Methods:1. baPWV and ABI were measured in 398 patients consecutively by collecting their medical history, chemical tests, echocardiography and angiography. A multivariate logistic regression analysis was done for CHD factors. The relation between baPWV and other variables was studied using Pearson correction analysis, a multivarious linear regression demonstrated the influencial factors of baPWV.2. ABI was tested in 1002 patients using Omron volume plethysmographic apparatus, patients were followed up to 1 year. Kaplan-Meier method was used to produce the life table, and Long-rank analysis was adopted for the analysis.3. Radial arterial waveforms were obtained from 122 subjects using Omron HEM-9000AI. CSBP and rAI were tested in 45 people without CHD and 46 male CHD patients. We analyzed the difference between men and women. In male CHD patients, multivarious linear regression analysis was used to evaluate their influential factors.4. CSBP was measured in the hospital in left ventricular hypertrophy patients using an electrocardiograph of Cornell voltage-duration product criterion. Antihypertensive treatment lasted at least one year in outpatients; at the end of the follow-up, electrocardiography, CBP and peripheral blood pressure were measured again, and compared different degree of peripheral BP and CSBP in the regression of LVH.Results:1. baPWV was higher and ABI was lower in the CHD group compared with non-CHD groups. Based on the result from logistic regression analysis, baPWV was not a significant independent variable for the prevalence of CHD, rather, age, gender and ABI values were. The result also demonstrated that systolic blood pressure influenced baPWV the most.2. In the low ABI group, elderly people and women were more likely to have CHD, hypertension, diabetes mellitus, shock, multiple vessel disease, chronic kidney failure, C-reactive protein, rennin, and fibrinogen. The rate of re-hospitalization was much higher in the low ABI group, for example, the rate was higher in the group with ABI...