A Correlation Analysis Of Pulse Pressure And Cardiopulmonary Exercise Capacity In Patients With Hypertension

Background and objectiveWith our country’s development in society and economy,the pace and style of people’s life have changed greatly,which leads to the increasing number of cardiovascular diseases.The corresponding mortality is also increasing year by year.All of this makes cardiovascular diseases get more and more people’s attention.Hypertension can lead to multiple cardiovascular events,and the mortality rate is rising year by year.As the most important risk factor for cardiovascular and cerebrovascular diseases,the epidemic situation is serious.And it is a chronic disease with high morbidity,high disability rate and heavy burden in China.The levels of systolic blood pressure（SBP）and diastolic blood pressure（DBP）have been used to assess the risk of cardiovascular events in patients with hypertension.In recent years,with more and more epidemiological investigation and clinical follow-up of the relationship between pulse pressure（PP）and cardiovascular disease carried out,we find the high-PP patients with hypertension have high risk of cardiovascular events.PP can predict the occurrence of cardiovascular and cerebrovascular disease.Cardiopulmonary exercise test（CPET）means that we can obtain the parameters of hemodynamics and oxygen dynamics through the total response of the cardiopulmonary circulatory system,hematopoietic system and musculoskeletal system in exercise.And through the parameter we can make accurate judgments of the function of cardiopulmonary circulatory system and the ability of exercise tolerance.In recent years,there have been many studies on cardiopulmonary exercise capacity and cardiovascular disease,including coronary heart disease,heart failure,rehabilitation of heart movement,hypertension and lung diseases.However,there is little research on the relationship between pulse pressure and cardiopulmonary exercise capacity.The study aims at analyzing the correlation between hypertension patients with different PP and their parameters through CPET and exploring the mechanism of how the PP affects cardiopulmonary exercise function,so as to provide more basis for the treatment and life guidance of hypertension patients.MethodThe study sample consisted of 103 patients who hospitalized in our center from September 2016 to October 2017,among which 73 patients with primary hypertension（PH）were divided into two groups according to PP:PP<60mmHg（n=40）and PP≥60mmHg（n=33）.30 cases of people without hypertension were selected as control group.All patients underwent CPET and Ultrasonic Cardiogram（UCG）.Age,sex,course of hypertension,BMI,SBP,DBP,PP,left ventricular mass index（LVMI）and other general clinical data were taken respectively in PH and non-PH groups.In addition,according to the CPET instrument,We extracted peak oxygen uptake per kg of body weight（peak VO₂/kg）,peak oxygen uptake as a percentage of expected value（peak VO₂%pred）,metabolic equivalent at peak oxygen uptake（peakMets）,oxygen uptake per kg of body weight@AT（VO₂/kg@AT）,metabolic equivalent@AT（Mets@AT）.Compare these CPET index between the control group and the PH group,besides,compare the age,sex,BMI,SBP,DBP,PP,LVMI of the two group.Compare all of thse indicators between the PP<60mmHg group and PP≥60mmHg group of PH.Moreover,analyze the correlation between PP and peak VO₂/kg、peak VO₂%pred,besides,analyze the risk factors for cardiopulmonary dysfunction.SPSS21.0 was used to analyze all the data.Result1.Compared with the control group,the SBP and LVMI increased and the peak VO₂/kg、peak VO₂%pred、peak Mets、VO₂/kg@AT and Mets@AT declined in hypertensive patients and the difference was statistically significant（P<0.05）.2.2.Compared the PH patients,there were significant differences in age、SBP、LVMI、the course of hypertension between PP<60mmHg group and PP≥60mmHg.The PP≥60mmHg group had lower peak VO₂/kg、peak VO₂%pred、Mets、VO₂/kg@AT and Mets@AT,and the difference was statistically significant（P<0.05）.3.The correlation analysis showed that pulse pressure was negatively correlated with peak VO₂/kg,and pulse pressure was negatively correlated with peak VO₂%pred.4.Multivariate Logistic regression analysis showed that pulse pressure was an independent risk factor for cardiopulmonary dysfunction in patients with hypertension.Conclusion1.Cardiopulmonary function was impaired in patients with hypertension.2.Compared with the PP<60mmHg group,the cardiopulmonary function was decreased in PP≥60mmHg group.PP was negatively correlated with cardiopulmonary function.3.PP was an independent risk factor for cardiopulmonary dysfunction in patients with hypertension.