The Relationship Between Pulse Pressure And Pulse Pressure Index And Coronary Heart Disease In Patients With Hypertension

The first part:The relationship between pulse pressure,pulse pressure indexes and coronary heart disease in hypertensive patients among Beijing adultsObjectiveTo investigate the relationship between pulse pressure(PP),pulse pressure index(PPI)and coronary heart disease(CHD)in hypertensive patients among Beijing adults.MethodsBeijing Chronic Diseases Survey 2011 used a multiple stage,random cluster process to yield a representative sample of Beijing adults aged 18 to 79 years.Pulse pressure(PP)was defined by systolic blood pressure(SBP)minus diastolic blood pressure(DBP)and pulse pressure index(PPI)by the ratio of PP/SBP.Logistic regression analysis was used to analyze the the relationship between PP,PPI and coronary heart disease(CHD)in hypertensive patients.ResultsA total of 7 563 hypertensive patients from Beijing Chronic Diseases Survey 2011 were enrolled in this study.The average age of all participants was(51.7±12.4)years old.Among 7 563 hypertensive patients,4 120(54.2%)were males,and 799(10.6%)were CHD patients.The PP and PPI were higher in hypertensive patients aged 60 to 79 years compared with those aged 18 to 59 years[PP:68.1 mmHg(1 mmHg=0.133 kPa)vs.52.4 mmHg,P<0.001;PPI:0.44 vs.0.36,P<0.001].They were also higher in CHD patients than those without CHD(PP:61.0 mmHg vs.55.5 mmHg,P<0.001;PPI:0.41 vs.0.37,P<0.001).Logistic regression analysis demonstrated that after adjustment of age,gender,body mass index,district,education level,current smoking and alcohol drinking,PPI was independently related to CHD in hypertensive patients[odds ratio(OR)=1.18,95%confidence interval(CI):1.04?1.33,P=0.008];After adjustment of age,gender,body mass index,place of residence,education level,current smoking,alcohol drinking and antihypertensive drug therapy,the relationship between PPI and coronary heart disease is no statistically significant.Conclusion PPI is related to CHD in hypertensive patients among Beijing adults after adjustment of age,gender,body mass index,district,education level,current smoking and alcohol drinking and this correlation is no statistically significant after adjustment of antihypertensive drug therapy.The second part:The relationship between ambulatory pulse pressure,ambulatory pulse pressure indexes and coronary heart disease in hypertensive patientsObjectiveTo investigate the relationship between 24-hour ambulatory pulse pressure(24hPP),24-hour ambulatory pulse pressure index(24hPPI),night-time ambulatory pulse pressure index(NPPI)and coronary heart disease(CHD)in hypertensive patients.MethodsAll participates underwent ambulatory blood pressure monitoring(ABPM)in Fuwai Hospital from May 2016 to July 2016,24hPP,24hPPI and NPPI were calculated to analyse their relationship with CHD occurrence.24hPP was defined by 24-hour mean systolic blood pressure(24hSBP)minus 24-hour mean diastolic blood pressure(24hDBP),24hPPI by the ratio of 24hPP/24hSBP and NPPI by the ratio of night-time(22:00?06:00)PP/SBP.ResultsA total of 305 participates were enrolled in this study.There were 222(72.8%)hypertensive patients.The 24hPP,24hPPI and NPPI were higher in hypertensive participants than normotensive participants[24hPP:49.0mmHg(1mm Hg=0.133 kPa)vs.42.2mmHg,P<0.001;24hPPI:0.39 vs.0.37,P=0.004;NPPI:0.40 vs.0.38,P=0.009].Among all hypertensive participants,the 24hPP,24hPPI and NPPI were higher in participants with CHD than those without(24hPP:50.9mmHg vs.47.0mmHg,P=0.013;24hPPI:0.41 vs.0.38,P<0.001;NPPI:0.42 vs.0.38,P<0.001).Logistic regression analysis demonstrated that after adjustment of age,gender,body mass index and antihypertensive drug therapy,24hPPI and NPPI were independently related to CHD inhypertensive patients[24hPPI:odds ratio(OR)=1.98,95%confidence interval(CI):1.11?3.52,P=0.021;NPPI:OR=2.26,95%CI:1.29-3.97,P=0.004].The receiver operator characteristic(ROC)curve analysis showed that 24hPPI and NPPI were superior to 24hPP in the screening and prediction of CHD in hypertensive patients.Conclusion24hPPI and NPPI are closely related to CHD in hypertensive patients and they are superior to 24hPP in the prediction of CHD.