Analysis On The Relation Of Atherosclerosis Interrelated Disease And Aortic Pulse Wave Velocity

Objective1. To build up the normal value of PWV in healthy middle and old subjects and study the PWV trend according to age.2. To study the influence of AID (essential hypertension, coronary atherosclerotic heart disease, diabetes mellitus, stroke) on the aorta, that is to say, the relation of these four kinds of diseases and PWV.MethodWe analyzed the healthy check-up data, total 1621 subjects, the age 31-85 years old, in Qilu Hospital of Shandong University between Aug. 2004 and Feb. 2005. According to the diagnostic standards of WHO, we took 229 subjects with EH, 157 subjects with CAD, 89 subjects with DM and 68 subjects with stroke as the AID single disease statistics data. According to the diagnostic guideline of WHO, we took 187 subjects with EH complicated with CAD, 59 subjects with EH complicated with DM, 31 subjects with EH complicated with stroke, 30 subjects with CAD complicated with DM, 36 subjects with CAD complicated with stroke and 30 subjects with DM complicated with stroke as the AID two compound diseases data. According to the diagnostic guideline of WHO, we took 42 subjects with EH complicated with CAD and DM, 70 subjects with EH complicated with CAD and stoke, 6 subjects with EH complicated with DM and stroke, 8 subjects with CAD complicated with DM andstroke as the AID three compound diseases data. According to the diagnostic guideline of WHO, we took 34 subjects with EH complicated with CAD , DM and stroke as the AID four compound diseases data. According to the western medicine clinical trial guideline, we took 545 health subjects as the PWV normal value statistics data. We selected the layers in which there have no significant difference on age, BMI and waist/hips ratio. We applied SPSS 11.5 for Windows to analyze the data. Results1. We built up the normal PWV value in middle and old healthy subjects according to age groups. There is no significant difference between the old-age men and women PWV value(11.67±2.99 and 11.33±2.87m/s, />=0.380). Age and PWV show the positive relation [ r =0.472, PO.001, PWV (m/s) = 3.450-f- 0.128Age(year) ] .2. The analysis of single disease: There is no significant difference on age, BMI and waisthips ratio in each group. The PWV values of EH group, CAD group, DM group and stroke group are significant higher than the value of normal group (P= 0.000, P- 0.029, P—0.005) , and the values of EH group are significant higher than the value of CAD group and stroke group (P=0.000, P=0.003) .3. The emalysis of two compound diseases: There is no significant difference on age, BMI and waist/hips ratio in each group. The PWV values of EH complicated with CAD group and EH complicated with DM group are significant higher than the value ofCAD complicated with stroke group (P=0.024, P=0.008) .4. The united analysis of four diseases:(1) Except the stroke group, the PWV value of the other groups are all significant higher than the value of normal group.(2) Hypertension is the essential disease: The PWV value of EH complicated with CAD , DM and stroke group is significant higher than the value of EH group, EH complicated with CAD group, EH complicated with stroke group, EH complicated with CAD and stroke group (P=0.000, P=0.000, P= 0.002, P—0.001) . The PWV value of EH complicated with CAD and DMgroup is significant-higher than the value of EH group (P=0.049) .(3) CAD is the essential disease: The PWV value of EH complicated with CAD , DM and stroke group is significant higher than the value of CAD group, EH complicated with CAD group, CAD complicated with DM group, CAD complicated with stroke group and EH complicated with CAD and stroke group (/>=0.000, ^=0.000, P=0.002, P=0.000, P=0.001) .ThePWV value of EH complicated with CAD and stroke group, EH complicated with CAD and DM group and EH complicated with CAD group is significant higher than the value of CAD group (P= 0.003, /)=0.000, P=0.000) .The PWV value of EH complicated with CAD and DM group is significant higher than the value of CAD complicated with stroke group (/>=0.007) .(4) DM is the essential disease: The PWV value of EH complicated with CAD , DM and stroke group is significant higher than the value of DM group, CAD complicated with DM group (P=0.001, P=0.002) .(5) Stroke is the essential disease: The PWV value of EH complicated with CAD, DM and stroke group is significant higher than the value of stroke group, EH complicated with stoke group, CAD complicated with stoke group, EH complicated with CAD and stroke group (i>=0.000, P=0.002, P=0.000, /=0.001) .Conclusions1. Build up the normal PWV value in middle and old health subjects according to age layer. There is no significant difference between the PWV value of old-age men and women.2. Build up the regression line between PWV and age, and certain the positive relation of the two indexes.3. The aorta elasticity descent to different degree in EH, CAD, DM and stroke subjects. According to the relation between the single disease and the aortic PWV, the disease from strong to weak one by one in order is: EH > DM > CAD > stroke.4. The two compound diseases with the aortic PWV relation from strong to weak one by one in order is: EH complicated with DM group > EH complicated withCAD group > EH complicated with stroke group > CAD complicated with DM group > DM complicated with stroke group > CAD complicated with stroke group.5. The relation between the compound diseases with the aortic PWV: (l)Total trend is, increasing with the comlplications, the aortic PWV accelerates. (2)While the essential disease is given, the influence of the complication upon the aortic PWV one by one in order is: complicated with EH > complicated with DM > compl icated with CAD > complicated with stroke.6. This research analysis shows that EH is the most important disease that affects the aortic elasticity (aorta stiffness), DM is the next in order, CAD and stroke are relative the most smallest. That is to say, there is certain value in the aorta PWV to reflect the artery damage in EH and DM, but the value in CAD and stroke lack enough basis. Traditionally the method using the carotid artery to evaluate the degree of CAD and cerebral vessel disease lacks the basis of theories and fulfillment.