Clinical Characteristic Of The Eldly Patients With H-type Hypertension

Objective: To compared the difference of clinical characteristics between eldly patients with H-type hypertension and the population with non-H-type hypertension,and improving the therapy of hypertension.Methods: This retrospective-sectional study used the hospitalized patients with hypertension in the First Affiliated Hospital of Guangxi Medical University,and all of their age was ≥65 years.All of them were divided into two groups according to the plasma homocysteine(Hcy)concentration,H-type hypertension groups(plasma Hcy>15μmol/L)and non-H-type hypertension groups(plasma Hcy≤15μmol/L).Analysis the difference of clinical characteristics in their sexy ratio,age,body mass index,systolic blood pressure(SBP),diastolic blood pressure(DBP),complications(cardiovascular diseases,stroke and diabetes mellitus),biochemical indicators including the levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein(LDL-c),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPBG),HbA1 c,K+,thyroid stimulating hormone(TSH),24 h urinary protein(24hU-pro),24 h urinary microalbumin(24hU-MALB).And comparing the degree ofventricular hypertrophy by their cardiac echocardiography including interventricular spetum thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(EF)and left ventricular mass(LVM),left ventricular mass index(LVMI).Result:A total of 224 cases were participated the study,aged 65 to 95 years,the average age was 74.32 ± 7.32,including 98 males and 126 females.They were divided into H-type hypertension groups(plasma Hcy>15μmol/L)and non-H-type hypertension groups(plasma Hcy≤15μmol/L).The difference of body mass index,number of people drinking or smoking for two groups was insignificant(p>0.05).But it was different sex ratio as 52.4% was male in the H-type hypertension group and only 36.1% was male in the group with non-H-type hypertension,the statistically was significant(p<0.05).Morever,the systolic blood pressure(SBP)in the H-type hypertension group was higher than the population with non-H-type hypertension(p<0.05),but the diastolic blood pressure(DBP)was insignificant(p>0.05).The number of people with complications such as cardiovascular diseases and stroke in the H-type hypertension group was more than the population with non-H-type hypertension(p<0.05).The level of total cholesterol(TC),blood urea nitrogen(BUN),creatinine(Cr)and uric acid(UA)in the H-type hypertension group were higher(p<0.05).But the level of high density lipoprotein cholesterol(HDL-c)was lower in the H-type hypertension group(p < 0.05).The difference of triglyceride(TG),low density lipoprotein cholesterol(LDL-c),thyroid stimulating hormone(TSH),K + concentration,fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPBG),Hb A1 c,24h-Urinary protein(24hU-pro)and 24 h Urinary microalbumin(24hU-MALB)wereinsignificant(p>0.05).The left ventricular mass index(LVMI)and the number of left ventricular hypertrophy(LVH)in the H-type hypertension group were more than the population with non-H-type hypertension(p<0.05).Conclusion: The eldly patients with H-type hypertension had a higher average age and a greater proportion of male.The chance of complications included cardiovascular diseases,stroke,renal dysfunction and left ventricular hypertrophy were more than the population with non-H-type hypertension.The blood biochemical indicators and other metabolic abnormalities occurred more obvious.The study reveals that the prognosis of elderly patients with H-type hypertension is worse.