Clinical Study Of The Early Screening At High Risk Of Coronary Heart Disease In Mild To Moderate Hypertension

Clinical study of the early screening at high risk of coronary heart disease in mild to moderate hypertensionObjective:To explore the possible of early screening at high-risk coronary heart disease(CHD) who may not have clinical features of the heart, brain, kidney and other target organ damaged in patients with mild to moderate hypertension. To study the characteristics of hypertension complicated by CHD in the bioche-mical, MA, and serum levels of inflammatory factors MCP-1and VCAM-1, vascular function, cardiac structure and function.Explore the early identification of high risk of hypertension complicated by CHD in clinical.Methods:Patients with mild to moderate hypertension were divided into two groups based on coronary angiography, coronary CT findings:Simple mild to moderate hypertension group;Mild to moderate hypertension+CHD group;Control group were the patients for the same period in our hospital for coronary angi-ography or coronary CT findings were normal, and to exclude a history of hypertension(In this study,some patients selected for retrospective).Three groups of patients were excluded diabetes, autoimmune diseases, liver, renal insufficie ncy, arteritis, Raynaud’s disease, secondary hypertension, valvular heart disease, non-coronary heart disease and anemia,and exclusion of diagnosed cardiovascu-lar and cerebrovascular diseases (cerebral hemorrhage, cerebral infarction, myo-cardial infarction, angina, heart failure),patients were in sinus rhythm,urine routi-ne examination of urine protein negative.Grouped as follows:Simple hypertensi-on group (n=49);hypertension+CHD group(n=31);control group (n=31).Experime-nts to compare the three groups of patients with the general age, gender, smo-king rate, BMI, WHR, blood pressure;Observed three groups of patients wheth-er differences in biochemistry, lipids, uric acid, glucose, liver and kidney func-tion;Observed three groups of patients whether have the UACR abnormalities and differences;Observe the three groups of patients with serum MCP-1and VCAM-1content;Observed three groups of patients with vascular function ABI and BaPWV;Observed three groups of cardiac structure, function.and determin-ation of LVMI in LVEF, E/A and Tei index.Results:Undergoing coronary angiography or coronary CT examination in80patients with mild to moderate hypertension,a total of31patients with CHD, incidence of38.75%(31/80).Three groups of patients’ gender, age, smoking rate, BMI,WHR were no significant difference,were comparable. Simple hypertension group and hypertension+CHD group systolic blood pressure.diastolic blood pre-ssure compared with the control group were significantly higher (P<0.01),comp-arison of blood pressure between the two groups no significant difference; There were not significant differences in FPG, TC, TG.HDL-C,LDL-c and Crb etween3groups (P>0.05).Compared with control group:Simple hypertension g roup and hypertension+CHD group, uric acid were significantly increased (P<0.01), and between uric acid levels in simple hypertension group, and hyperten sion+CHD group had a significant difference(P<0.05)too.Compared with control group:simple hypertension and hypertension+CHD group, UACR were statistic-ally significant(P<0.05).Between simple hypertension group and hypertension+CHD group UACR value was also significant difference(P<0.05). Serum of MCP-1content:Simple hypertension group and hypertension+CHD group compa-red with control group serum of MCP-1were significantly different (P<0.05) simple hypertension and hypertension+CHD group compared with control group, serum MCP-1levels increased.there was significant difference between simple hypertension and hypertension+CHD group (P<0.05). Serum of VCAM-1content:Simple hypertension group and hypertension+CHDgroup serum VCAM-1levels compared with the control group increased (P<0.05), Simple hypertensi-on group and hypertension+CHD group serum VCAM-1content increased (P <0.05).Vascular function:Simple hypertension group, hypertension+CHD group and control group ABI was statistical difference (P<0.05).between simple hyp e-rtension group and hypertension+CHD group two groups ABI were also sig ni-ficant difference(P<0.05).Simple hypertension group and hypertension+CHD group BaPWV was higher than control (P<0.05), between groups of simple hypertension and hypertension+CHD BaPWV also significant difference(P<0.0 5).Cardiac function parameters:Simple hypertension group and hypertension+C HD group than control group LVMI increase were significantly different(P<0.05), between simple hypertension group and hypertension+CHD group compare d LVMI was no significant difference (P>0.05).Among the three groups LVEFwas not statistically significant (P>0.05).Simple hypertension group and hyper te-nsion+CHD group than the control group E/A lower and there was a signifi ca-nt difference (P<0.05). Compared to the E/A,simple hypertension group and hypertension+CHD group was no significant difference (P>0.05).Comparison o f Tei index:Compared with the control group simple hypertension group and h yp-ertension+CHD group Tei index increased (P<0.05),Tei index was no signif ic-ant difference between simple hypertension group and hypertension+CHD gro up(P<0.05).Conclusion:1.Patients with mild to moderate hypertension, although the course of the disease was relatively short, there was no clinical features of the heart, brain, kidney and other target organ damage in the performance of evidence, but there were a considerable number of patients with CHD.2.CHD did not depend on the level of blood pressure occurred.3.Serum uric acid, UACR, serum inflammatory factors MCP-1, VCAM-1levels in hypertension+CHD group significantly abnormal, took into account the above characteristics could be used as early in the mild to moderate hypertension screening predictor of CHD at high risk.4.Vascular function,patients with mild to moderate hyperten-sion and CHD characterized by increased vascular stiffness and increased vas-cular resistance.5.Cardiac function, Simple hypertension group and hypertensi-on+CHD group patients had shown diastolic dysfunction, but no characteristic difference between the degree of diastolic dysfunction.