Explore The Relationship Between H-hypertension And Coronary Disease

Objective By detecting object into plasma homocysteine (Hcy) levels,According to theresults of coronary angiography (the CAG), On patients with primary hypertension withcoronary heart disease (CHD) the relationship between level of serum homocysteine(Hcy)、H hypertension and coronary artery lesions.Methods Selected objects selected from January2012to January2013yanan universityaffiliated hospital of suiyeh branch within2163cases of primary hypertension diagnosisstandard, ward suspected coronary heart disease (CHD) combined,Using enzymecirculation method in patients with serum Hcy,all included in the patients with the CAG,based on the CAG results.Accounted for123cases of coronary heart disease, coronaryheart disease (CHD) of40cases.1.According to the result of the CAG, determination ofHcy levels, according to the different patients on the basis of10umol/l, will Hcy≧10umol/l patients divided into H hypertension group (113cases), the Hcy<10umol/lpatients divided into pure hypertension group (50cases), the general clinical data tocompare the two groups of patients,the diagnosis of coronary heart disease patients ingroup H hypertension and compare the percentage of simple hypertensiongroup;2.According to the results of CAG,according to the diagnosis of coronary arterydisease in patients with coronary artery disease count divided into single-vessel disease(58cases), double-vessel disease (35cases),multi-vessel disease (30cases),more Hpercentage of hypertension and hypertension group share in each group,Hcylevels,Gensini points;3.According to the result of the CAG, With Gensini integral methodas the evaluation standard, determine coronary artery lesion severity, compare Hhypertension with simple hypertension group Gensini score,at the same time to explore the correlation between Hcy and Gensini score;4.According to the results of CAG, thediagnosis of coronary heart disease patients before admission in accordance with theclinical manifestations are divided into stable angina group (53cases),unstable anginagroup (37cases),acute myocardial infarction group (33cases),Comparing H hypertensiongroup and the percentage of simple hypertension group in groups and Hcy levels;5.usingmultivariate binary Logistic regression analysis of risk factors for coronary artery diseasescreening.SPSSl7.0software is used to analyse the data.Homogeneity of variance and the normalinspection first, and qualified measurement data using mean+/standard deviation(X+/S), two groups of samples to compare using t test, three groups using analysis ofvariance.Count data using the chi-square test.Two continuous variables using Pearsoncorrelation analysis.Binary classification Logistic regression analysis is adopted toimprove the screening of coronary heart disease risk factors, with P<0.05was statisticallysignificant.Results1. H hypertension patients with simple hypertension group in sex, smoking history,drinking history, history of diabetes, age, body mass index (BMI), total cholesterol (TC),diastolic blood pressure, triglyceride (TG), low density lipoprotein cholesterol (LDL-C),systolic blood pressure, high density lipoprotein cholesterol (HDL-C)-aspects ofcomparison, there were no statistically significant difference (p>0.05).diagnosis ofcoronary heart disease patients in group H hypertension with pure percentage inhypertension group with statistical significance (P <0.05).H hypertension group anddiagnose patients with coronary heart disease (CHD) in patients with simple hypertensiongroup, the difference was statistically significant (p <0.05).2. H combined hypertension and CHD combined with simple hypertension andcoronary artery Gensini score comparison between CHD and shown H Gensini scorehypertension group (52.35+/41.2) higher than that of pure hypertension group(34.2+/12.4), statistically significant difference (p <0.05). 3. H combined hypertension and CHD combined with simple hypertension and CHDin single lesion group, the double branch lesion group, the percentage of multivessellesions in the group was statistically significant (p <0.05), H hypertension with simplehypertension group in multivessel lesions and single lesion group percentage ofstatistically significant (p<0.05), while in double branch lesions and single lesion groupand multivessel lesions and pathological changes of double branch group percentage ofno statistically significant (p>0.05).4.H combination of hypertension and coronary heart disease (CHD) in patients withmultivessel disease group, double branch lesion group, single lesion group of Hcy levels(28.9+/8.56)ummol/l respectively,(22.4+/6.62)ummol/l and (19.8+/6.66) ummol/l, Interms of Hcy levels, multivessel lesions group is higher than the double branch lesionsand single lesion group (p<0.002);The double branch lesions and single lesion group isno statistical significance (p>0.05), but showed a trend of increase;Multivessel lesions,double branch lesions and single lesion group Gensini score respectively(91.4+/44.7),(46.9+/24.3) and (22.2+/15.5), and multivessel disease group Gensini scoreis significantly higher than double branch lesions and single lesion group(p<0.001);Double branch lesion group Gensini score compared with single lesion groupwith statistical significance (p<0.001).5. H combined hypertension and CHD combined with simple hypertension and CHDgroup (SAP) in stable angina, unstable angina pectoris (UAP), acute myocardialinfarction (AMI) group of the ratio of statistically significant (p <0.001), H hypertensionwith simple hypertension group in stable angina pectoris group and unstable anginagroup with statistical significance (p<0.05), H hypertension with simple hypertensiongroup in stable angina and acute myocardial infarction with statistical significance(p<0.05),H hypertension with simple hypertension group in unstable angina and acutemyocardial infarction (AMI) has no statistical significance (p＞0.05).6.H group combination of hypertension and coronary heart disease in patients withstable angina, unstable angina and acute myocardial infarction group of Hcy were (20.0+/6.26)umol/l,(24.4+/8.54)umol/l,(26.3+/7.67)umol/l, Comparison between threegroups, The difference was statistically significant (P<0.05), On the level of Hcy, AMIand UAP groups and SAP group than the difference was statistically significant (p <0.05), acute myocardial infarction group of Hcy levels compared with unstable anginagroup differences have no statistical significance (p>0.05).7.Pure hypertension group serum Hcy levels and Gensini score no correlation(r=0.178,p>0.178),serum Hcy and H hypertension group Gensini score was positivelycorrelation (r=0.266,p<0.05).8.With age, sex, blood lipid,BMI,Hcy,H blood pressure indicators such as theindependent variable as a candidate risk factor for coronary heart disease,coronarydisease as the dependent variable, using the multi-factor classification Logistic regressionanalysis for the second screening of coronary heart disease risk factors,The results foundthat Hcy, H high blood pressure is a risk factor for coronary heart disease (CHD)Conclusion1. H hypertension and Hcy are closely related to coronary heart disease (CHD)and thecount and the degree of stenosis of coronary vascular lesions.2. H hypertension and Hcy are associated with coronary vascular lesions plaquestability and coronary vascular lesions plaque vulnerability.