The Relationship Of Severity Of Coronary Artery Stenosis And Blood Pressure Indices To Left Ventricular Hypertrophy In Essential Hypertensive Patients

Objective:To investigate the relationship of severity of coronary artery stenosis and blood pressure indices to left ventricular hypertrophy in essential hypertensive patients.Methods:157 essential hypertensive patients admitted in cardiology department in the first affiliated hospital of Nan chang University from January, 2007 to February,2008 were elected as objects.Firstly, blood pressure were determined, then pulse pressure,pulse pressure index and vascular overload index were calculated..Secondly, serum levels of total cholesterol(TC), triglycerides(TG), low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol (HDL-C) were determined. Thirdly, left ventricular end-diastolic diameter (LVDD), interventricular seprum thickness(IVST)and Left ventricular posterior wall thickness (LVPWT)were measured by echocardiography ,then left ventricle mass index (LVMI) was calculated. Finally,all patients underwent coronary angiography,and the severity of coronary artery stenosis was assessed by coronary artery score (Gensiniscore) and the number of diseased coronary branches. All patients were divided into subgroups: 1. The LVH subgroup (male LVMI≥125g/m2, female LVMI≥120g/m2) and the non-LVH subgroup(male LVMI<125g/m2, female LVMI<120g/m2). 2. The low PP subgroup and the high PP subgroup(PP<65mmHg and≥65mmHg). 3. The low PPI subgroup and the high PPI subgroup(PPI<0.5 and≥0.5).4. The low VOI subgroup and the high VOI subgroup(VOI<40mmHg and≥40mmHg).Results:1.There were significant differences between LVH subgroup and non-LVH subgroup in age,EH history,SBP,DBP,PP,PPI and the score of coronary artery stenosis (P<0.01).We chose the score of coronary artery stenosis as the dependent variable,chose LVMI as the independent variablei,using the simple correlation analysis.The results shown that the score of coronary artery stenosis had positive correlation with LVMI.(r=0.461,P<0.01). 2. There were significant differences between the low PP subgroup and the high PP subgroup in age,SBP,DBP,LVMI, the score of coronary artery stenosis and the incidence of left ventricular hypertrophy (P<0.01). 3. There were significant differences between the low PPI subgroup and the high PPI subgroup in age, EH history, SBP,DBP,LVMI, the score of coronary artery stenosis and the incidence of left ventricular hypertrophy (P<0.01). 4. There were significant differences between the low VOI subgroup and the high VOI subgroup in age, EH history, SBP,DBP,LVMI, the score of coronary artery stenosis and the incidence of left ventricular hypertrophy (P<0.01). 5. We chose LVMI as the dependent variable,chose every dangerous factor as the independent variablei,using the simple correlation analysis. The results shown that LVMI had positive correlation with SBP,PP,PPI, VOI ,age,EH history and the score of coronary artery stenosis (P<0.01),had negative correlation with DBP(P<0.05),and the correlation coefficient of PPI was the lagest. After the multiple stepwise regression, the standardized regression coefficient of PPI was the largest,then VOI, PP and age in order.Conclusions: (1)PP,PPI ,VOI and the severity of coronary artery stenosis in essential hypertensive patients have significantly positive relationship with left ventricular hypertrophy, among which PPI plays the most important role,then VOI,PP and the severity of coronary artery stenosis in order. (2)Left ventricular hypertrophy in essential hypertensive patients is a independent risk factor of coronary heart disease. (3)PP,PPI and VOI are predictive factor of left ventricular hypertrophy and cardiovascular accident in essential hypertensive patients. (4)PPI has much more advantages than VOI and PP on predicting the risk of left ventricular hypertrophy and cardiovascular accident in essential hypertensive patients.