Exploration On The Relevant Factors Of Left Ventricular Hypertrophy With Essential Hypertension In The Elderly

Objectives: To explore the relevance of pulse pressure(PP),pulse pressure index(PPI),homocysteine(Hcy),interleukin-6(IL-6)and related clinical data with left ventricular hypertrophy(LVH)and its configuration with essential hypertension in the elderly,and establish the prediction model of LVH with essential hypertension in the elderly,providing elicitation of diagnosis and treatment for early recognition and intervention of LVH affecting factors in elderly patients with essential hypertension.Methods: A total of 115 patients with primary hypertension aged ≥60 years old with complete clinical data were selected from the geriatrics Department of the Fifth Affiliated Hospital of Kunming Medical University from October 2021 to December 2022.All subjects underwent ultrasonic cardiogram(UCG)examination to measure left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),and calculate left ventricular mass index(LVMI)and relative wall thickness(RWT).According to LVMI,patients were divided into non-left ventricular hypertrophy group(NLVH,n=50)and LVH group(n=65).LVH group was further divided into centripetal hypertrophy group(LVH1 group,n=30)and centrifugal hypertrophy group(LVH2group,n=35)according to RWT.Gender,age,body mass index(BMI),hypertension level,duration,the blood pressure controlling,family history,smoking history,alcohol consumption history,diabetes history,24-hour dynamic pulse pressure(24h APP),24-hour dynamic pulse pressure index(24h APPI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),and triglycerides were collected(TG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),Hcy and IL-6 were compared and correlation analysis was conducted.The influencing factors of LVH were analyzed by binary logistic regression.Receiver operating characteristic curve(ROC)was drawn to establish the prediction model of LVH in elderly patients with essential hypertension.Results:1、The levels of PP,PPI and IL-6 in hypertensive LVH group were significantly higher than those in NLVH group(P<0.05),there was no significant difference in Hcy level between LVH group and NLVH group(P>0.05),and there was no statistical difference in PP,PPI,IL-6 and Hcy in different configurations of LVH group(P>0.05).There were statistically significant differences in gender,BMI,proportion of level 3hypertension,course of hypertension,blood pressure compliance rate,drinking history and SBP level between hypertensive LVH group and NLVH group(P<0.05).2、Univariate correlation analysis showed that LVMI was positively correlated with PP,PPI,IL-6,duration of hypertension,level 3 hypertension and substandard blood pressure control(P<0.05).3、Binary Logistic regression analysis showed that PP ≥ 51.93 mm Hg,PPI ≥0.41,IL-6≥4.07pg/m L,female,level 3 hypertension and substandard blood pressure control were affecting factors for LVH in elderly patients with essential hypertension(P<0.05).4、ROC curves were drawn using PP,PPI,IL-6,female,level 3 hypertension and substandard blood pressure control as predictive indicators,and the areas under the curves were 0.682,0.720,0.701,0.657,0.687 and 0.666,respectively.The corresponding cut-off values PP=59.08 mm Hg,PPI=0.459,IL-6=6.825pg/m L,and sensitivities were 47.70%,46.20%,43.10%,75.40%,95.40%,50.80%,respectively.The specificity was 90.00%,96.00%,90.00%,56.00%,42.00% and 84.00%,respectively.And the accuracy was 66.09%,66.96%,63.48%,66.96%,72.17% and64.35%,respectively.Combined with the six affecting factors can accurately predict the occurrence of essential hypertension LVH in the elderly.The sensitivity,specificity and accuracy of prediction were 87.70%,84.00% and 85.90%,respectively.Conclusions:1、PP,PPI and IL-6 were closely related to the occurrence of essential hypertension LVH in the elderly,but had no obvious correlation with LVH configuration.The level of Hcy in the elderly population was generally high,and there was no obvious correlation with LVH and its configuration.2、PP,PPI,IL-6,female,level 3 hypertension and substandard blood pressure control are affecting factors for LVH in elderly patients with essential hypertension,and have certain predictive value for LVH,and the combined value of the six indicators is higher.