| Objective: This study through the determination of center and peripheral arterial systolic blood pressure(SBP),diastolic blood pressure(DBP)and pulse pressure(PP)in patients with coronary heart disease (CHD), explored the relevance of center and peripheral arterial pulse pressure and carotid atherosclerosis.Methods: Patients with CHD were chosen in the Second Hospital of Hebei Medical University cardiovascular medicine ward from December 2007 to October 2008. A total of 80 patients participated the trial, 45 males and 35 females, with Age of 23-79 years old, average age of 55.16±7.83 years. Inclusion criteria: Patients must meet the nomenclature and diagnostic criteria of Ischemic heart disease(WHO). Exclusion criteria:⑴Patients with familial hypercholesterolemia;⑵Insulin-dependent diabetic patients;⑶Patients with severe cardiac dysfunction;⑷Patients with secondary hypertension;⑸Serious liver and kidney dysfunction and infection;⑹Other diseases that affect pulse pressure (Such as severe anemia, hyperthyroidism, aortic insufficiency, congenital heart disease). The patients are all experienced the determination of carotid artery intima-media thickness and plaque score by the color Doppler ultrasound, then measured center SBP, DBP, PP by placed pigtail catheter in the ascending aorta. They were divided into two groups by carotid artery ultrasound results: plaque group 50 cases, 30 cases of non-plaque group. Comparison of age, central SBP, central DBP, central PP, peripheral SBP, peripheral DBP, and peripheral PP between the two groups used t-test. We analyzed the relationship between each factor and carotid artery intima-media thickness and plaque score by using multivariate linear regression analysis. PP≥50 mmHg is defined for wide PP. The patients were divided into two groups according to the level of PP. Analyzed the relationship between PP and incidence of carotid artery plaque by usingχ2 test. Statistical analysis of data was performed by using the SPSS13.0 statistical software pack for Windows. P<0.05 is deemed to have statistical significance.Results: 1. The level of age(63.58±7.42), central SBP (142.72±11.28), central PP(68.55±12.60), peripheral SBP (13 4.04±9.54) and peripheral PP(58.33±11.74) of patients with carotid artery plaque is significantly higher than that of age (47.30±7.98), central SBP(117.39±10.73), central PP(41.44±7.42), peripheral SBP (127.26±8.00), and peripheral PP (48.50±5.40) of patients in non-carotid artery plaque group, the differences of them have statistical significance(P<0.01). The level of central DBP (74.18±10.3), peripheral DBP (75.70±8.68) of patients with carotid artery plaque is lower than that of central DBP (75.96±8.53), peripheral DBP (78.76±6.74) of patients in non-carotid artery plaque group, but the differences of them have no statistical significance (P>0.05).2. Multiple linear regression analysis: Analysis which take carotid artery intima-media thickness for the dependent variable; age, center and peripheral SBP, DBP, PP as independent variables shows that age, center PP and peripheral PP are independent risk factors of carotid atherosclerosis (P<0.05). While the center and peripheral SBP, DBP can not enter the model at the stage of P>0.05, did not show the correlation with carotid atherosclerosis.3.Multiple linear regression analysis: Analysis which take plaque score for the dependent variable; age, center and peripheral SBP,DBP,PP as independent variables shows that age, center PP and peripheral PP are independent risk factors of carotid atherosclerosis(P<0.05). While the center and peripheral SBP, DBP can not enter the model at the stage of P> 0.05, did not show the correlation with carotid atherosclerosis.4.The relation between PP and the incidence of carotid atherosclerotic plaque: The incidence of carotid atherosclerotic plaque in patients with center PP≥50 mmHg is significantly higher than that in patients with center PP<50 mmHg. The number is 88.46% vs. 14.29%. The difference have great statistical significance (P<0.01). The incidence of carotid atherosclerotic plaque in patients with peripheral PP≥50 mmHg is significantly higher than that in patients with peripheral PP<50 mmHg. The number is 74% vs. 44.33%. The difference have great statistical significance (P <0.01).Conclusion: The level of age, central SBP, central PP, peripheral SBP and peripheral PP of patients with carotid artery plaque is significantly higher than those of patients in non-carotid artery plaque group, the differences of them have statistical significance(P<0.01). While the level of central DBP, peripheral DBP of patients with carotid artery plaque is lower than those of patients in non-carotid artery plaque group, but the differences of them have no statistical significance(P>0.05). The incidence of carotid atherosclerotic plaque in patients with wide PP is significantly higher than that in patients with narrow PP. By multiple linear regression analysis, we find that age, center PP and peripheral PP are independent risk factors of carotid atherosclerosis, and center PP is more relevant than peripheral PP. While the center and peripheral SBP, DBP did not show correlation. In conclusion, Center PP can be used as a high-risk prediction indicator for the occurrence of carotid atherosclerosis. |
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