Correlation Between Arterial Stiffness And Valvular Calcification In Elderly Patients With Isolated Systolic Hypertension

Objective:To observe the level of Pulse wave velocity%Ankle Brachial Index and the incidence of heart valve calcification in elderly patients with isolated systolic hypertension. Furthermore, we sought to explore the association between arterial stiffness and valvular calcification in elderly patients with isolated systolic hypertension.Method:1.166cases of elderly hypertension and34normotensive cases were admitted in our reaserch and their clinical datas were collected.2.To divide the cases into three groups according to the blood pressure results:isolated systolic hypertension group(n=80), systolic-diastolic hypertension group(n=86) and control group(n=34).3.Routine biochemical tests, ambulatory blood pressure, echocardiography, PWV, ABI were detected on all the research subjects.4. Comparing the basic clinical datas, PWV, ABI and valvular calcification in these three research groups, to analyze the relations between PWV、ABI and valvular calcification in isolated systolic hypertension patients.Result:1.(1) There were not statistically differences on age, gender, BMI, fasting plasma glucose, LDL, creatinine, clcium, phosphorus, coronary heart disease and diabetes in these three groups(P>0.05).(2) Blood pressure:systolic blood pressure and pulse pressure was higher in ISH group and SDH group than in control group (P<0.01); The pulse pressure was higher in ISH group than SDH group(P<0.01), systolic blood pressure were no statistically significant differences(P>0.05); diastolic blood pressure was lower in ISH group and control group than in SDH group (P<0.01), diastolic blood pressure in ISH group and control group were no statistically significant differences(P>0.05).2. PWV in ISH group and SDH group were higher than in control group(P<0.01), PWV in ISH group was higher than in SDH group(P<0.01).(2) ABI in ISH group and SDH group were lower than in control group(P<0.01), ABI in ISH group was lower than in SDH group(P<0.01).3.(1) There were34(42.50%) patients with valves calcification in ISH group,26(30.23%) patientss with valves calcification in SDH group and6(17.65%) patientss with valves calcification in control group. The incidence of valve calcification in ISH group and SDH group were much higher than in control group(P<0.01). The incidence of valve calcification in ISH group was higher than in SDH group(P<0.01).(2) In all valvular calcification patients, the incidence of aortic valve calcification was78.79%, mitral-aortic valve calcification was18.18%, mitral valve calcification was3.03%, the tricuspid and pulmonary valve calcification were not found, calcification of heart valves in these three groups were mainly pure aortic calcification.4.(1) In ISH, SDH and control group, the PWV was higher in patients with valvular calcification than in patients without valvular calcification(P<0.05), in these three groups the PWV were positively correlated with valve calcification, The correlation coefficients were0.571、0.487、0.425(P<0.01).(2) In ISH,SDH and control group, the ABI were lower in patients with valvular calcification than in patients without valvular calcification(P<0.05), in these three groups the ABI were negatively correlated with valve calcification, The correlation coefficients were-0.465、-0.383、-0.347(P<0.01).5.(1) In all the reaserch patients, pulse pressure positively correlated to PWV, The correlation coefficient was0.708(P<0.01).(2)Pulse pressure was negatively associated with ABI, the correlation coefficient was-0.403(P<0.01).(3)Pulse pressure was positively related to valvular calcification, The correlation coefficient was0.451(P<0.01).6. In logistic regression analysis on the risk factors for heart valve calcification, the valvular calcification was positively associated with smoking, pulse pressure, coronary heart disease, diabetes, hypertension and PWV(P<0.05). valvular calcification negatively correlated with ABI(P<0.05). valvular calcification was not linked with sex, age, TC, BMI, TG, LDL-C, calcium and phosphorus(P>0.05).Conclusions:1. Arterial stiffness and the incidence of valve calcification are higher in elderly patients with hypertension than in normotensive patients, however, Arterial stiffness and valve calcification is most common in patients with isolated systolic hypertension, arterial stiffness positively correlate with valvular calcification.2.Valvular calcification in patients with isolated systolic hypertension and systolic-diastolic hypertension mainly damage aortic valve, followed by aortic-mitral valve, pure mitral valve calcification was rare.3. Pulse pressure is associated with cardiac valve calcification, suggesting that with pulse pressure increasing, the incidence of valvular calcification increased.4. Smoking, increased pulse pressure, coronary heart disease, diabetes, hypertension and increased PWV, reduced ABI are risk factors for heart valve calcification.