Study On The Relationship Between Brachial-ankle Pulse Wave Velocity And Coronary Heart Disease In Elder Male Subjects

Objective and Background: With the improvement of people's living standard, the morbidity of cardiovascular and cerebrovascular disease shows a tendency to rise year by year. And it has already become an important public health problem of current society. And the arteriosclerosis plays an important role in the onset of these diseases. As a non-invasive index of assessing the degree of artery stiffness, the pulse wave velocity(PWV) is causing the attention day by day too. More and more clinical experiments verified that the increase of PWV is an independent risk factor of cardiovascular mortality in patients with essential hypertension, diabetes, glucose intolerance and end-stage renal disease. But, there are few corresponding data at present to prove whether it is meaningful among the old people. So we are trying to estimate the artery stiffness by non-invasive measurement of PWV and discuss the role of PWV as the risk factor of coronary heart disease in old males through this study.Methods: There were 89 old male subjects above 60 year-old selected into the study. These subjects were separated into patient group and control group by using the methods of coronary arteriongraphy or coronary artery CT scan and myocardial infarction history to confirm the diagnosis of coronary heart disease. At the same time, these patients were not suffering from the hypertension, diabetes, glucose intolerance and kidney disease. Two groups of research objects measured relevant parameters, such as pulse wave velocity, ultrasonic cardiography, blood pressure , biochemical markers of blood ,etc. respectively. The data are analyzed by t-test, logistic regression and multivariate linear regression with SPSS software version 11.5. A value of P <0.05 was considered significant in double-sided tests.Results: (1) There is no statistical significance in basic situations of patient group and control group, such as age, weight, height, body surface area, body massindex and heart rate, etc.. (2) There is no statistical significance between two groups of blood sugar , cholesterolemia and triglyceride, and hs-CRP is greater in patient group than in control group (Z =2.643, P<0.05). (3) Except diastolic pressure, systolic pressure (t =-2.938, P<0.05), mean arterial blood pressure (t =-3.201, P< 0.05) and pulse pressure (t =-5.038, P<0.05) are significantly higher in patient group than in control group. (4) There is no statistical significance between two groups of left ventricular internal diameter, interventricular septum thickness, aortic diameter, posterior left ventricle thickness, EF slope rate, left ventricular mass, left ventricular mass index and ejection fraction. ( 5) The baPWV of patient group is significantly higher than control group(t =-6.462, P<0.05). (6) It shows that baPWV (OR=2.750, 95%CI, 1.424-5.310, P<0.05) , pulse pressure (OR=1.092, 95%CI, 1.020-1.169,P<0.05) andhs-CRP (OR=1.785, 95%CI, 1.327-2.400, P<0.05) are selected into regression equation by logistic regression forward condition. (7) A multivariate linear regression with stepwise method demonstrates that PWV pulse pressure, mean arterial pressure, age and hs-CRP are selected into the equation (i?2=0.501, F=21.056). The equation is baPWV(m/s)=0.925+0.027xpulsepressure(mmHg)+0.073 xage(year)+0.100xhs-CRP (Conclusion: This experiment has got rid of the factor of mixing that hyperlipemia and diabetes cause danger to the blood vessel from design, thus it can prove that the increase of baPWV may be one of the independent risk factors of coronary heart disease in old males even more. Pulse pressure , age and hs-CRP are the important influencing factors to the baPWV among old males by multivariate linear regression. While predicting the morbidity of coronary heart disease in old males, baPWV is much more valuable than hs-CRP and pulse pressure which are already admitted extensively. The values of hs-CRP, systolic pressure, mean arterial blood pressure and pulse pressure in old coronary heart disease males are generally greater than those who are not suffering coronary heart disease, even if all of themare normotensive and in normal level of blood glucose and blood fat. It is necessary to control the blood pressure and inflammation more positively in the people who are suffering from coronary heart disease.