A Cross-sectional Study Of Risk Factors For Hypertension Complicated With Coronary Heart Disease In Different Altitude Areas

Objective The purpose of this study is to explore the influence of traditional risk factors on patients with hypertension and coronary heart disease under the special environment of high altitude,so as to provide reference for the primary prevention of cardiovascular disease in high altitude population.Methods From January 201 9 to January 2020,97 Tibetan patients with hypertension and coronary heart disease hospitalized in the Department of Cardiology of the people's Hospital of Tibet Autonomous Region(3658m)were selected as the plateau group,and 100 Han patients with hypertension and coronary heart disease hospitalized in the Fuwai Hospital of Beijing(43M)were selected as the control group according to 1:1 pairing by age.Results The average diastolic blood pressure in subjects at high altitude is 87.81±13.68 mmHg,while average diastolic blood pressure is 77.63±14.27mmHg at sea level.The change of diastolic bllood pressure in high altitude group is larger than that in seal level group(P<0.05).In high altitude group,some blood test indicators are different from sea level group,such as red blood cell(5.25±0.77 vs4.37± 0.50*1012/L),hemoglobin(160.66±20.03 vs 133.83±14.25 g/L),haematocrit(0.47±0.07 vs 0.39±0.04),cholesterol(3.70±1.00 vs 4.05±1.21 mmol/L),triglyceride(1.26±0.60 vs 1.68±0.64 mmol/L),low density lipoprot(2.26±0.82 vs2.52±0.74 mmol/L),high density lipoprotein(1.00±0.22 vs 1.12±0.30 mmol/L),fasting blood glucose(5.37±1.78 vs 6.94±2.53 mmol/L),uric acid(402.30±89.78 vs 329.96±93.74 umol/L)and homocysteine(15.91±3.58 vs 14.66±3.52umol/L)(P<0.05).Analysis of influencing factors shows that high density lipoprotein,uric acid,homo cysteine,and heart rate are correlated with hypertension and coronary heart disease at high altitude.In high altitude group,coronary artery lesion is most common with single vessel(54.64%).The Gensini score is different in two groups,32 in high altitude group and 30 in control group at sea level(P<0.05),and Gensini score is positively correlated with uric acid and homocysteine in high altitude group.Conclusions Traditional risk factors such as age,alcohol and blood lipid are still the main risk factors of hypertension with coronary heart disease in high altitude area.Uric acid,homocysteine and heart rate are correlated to cardiovascular disease at high altitude.The special environment of high altitude can aggravate the severity of the disease.Diastolic pressure is more significant in the change of hypertension in plateau area.