Relationship Between Cardiovascular Risks Factors And Severity Of Coronary Artery Disease In The Patients Of Different Genders

Background:Since1948the U.S. Public Health Service (US Public Health Service) scientists concerned about the harm of cardiovascular diseases (cardiovascular diseases, CVD), they started a well-known research named Framingham Heart Study under the co-ordination of the National Heart Institute (now renamed the National Heart, Lung, and Blood Institute, NHLBI). In this study they have proposed a high cholesterol, hypertension, smoking, diabetes, obesity and other CVD risk factors, and proposed male is an independent risk for CVD, but if women suffered from these diseases, the mortality rate was higher than men. With the development of scientific progress, the research on CVD especially the coronary heart disease was endless. The previous studies have focused on the risk factors for coronary heart disease, but now more and more studies have turned to analyze the relationship between cardiovascular risk factors and severity of coronary artery disease.Framingham heart study had shown that the gender is an independent risk factor for coronary heart disease. These years other research on risk factors for coronary heart disease also proves that the male coronary heart disease incidence was significantly higher than that of female, and female postmenopausal coronary heart disease incidence increased significantly. There are also many studies aimed at the gender differences of the risk factors for coronary heart disease, but the conclusions of these studies are different. In our study, we compared the relationship between coronary heart disease risk factors and severity of coronary artery disease in the patients of different genders. Objective (1) Compare the detection rate of coronary heart disease between different gender;(2) Compare the severity of coronary artery disease of male and female patients;(3) Compare gender difference of risk factors for coronary heart disease;(4) Study the relationship between risk factors and severity of coronary artery disease in different genders.Methods (1) Collected the cases of these who had gone to the General Hospital of Nanjing Military Region and accepted coronary angiography. Records of gender, age, hypertension, diabetes, smoking, serum total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, uric acid other basic information, and the results of coronary angiography. According to the selected standard finally elected in1786cases;(2) Set indicators according to the diagnostic standard, and calculate the Gensini score. Statistical analysis use SPSS17.0statistics software;(3) Compare the basic information of male and female patients;(4) Grouped by age, then compare the incidence and severity of coronary heart disease between different genders in different ages;(5) At first, single factor analysis the risk factors for coronary heart disease. Then analyze the male patient risk factors and female patient risk factors respectively. Finally, compare the risk factors for coronary heart disease between different genders;(6) First divides all patients into4groups according to Gensini score, and single factor analysis of risk factors of coronary heart disease and severity of coronary artery disease. Then analyze risk factors and coronary heart disease using Logistic regression analysis method. Finally, using Logistic regression analyze the male patient and female patient respectively.Results (1) Compared the basic information of the two different genders groups of the1786cases, then the mean age, hypertension, high cholesterol of female patient were significantly higher than male group (P<0.05). High LDL-C, low HDL-C, high UA, smoking of male patient grow were significantly higher than female grow (P<0.05). Either detection rate of coronary heart disease or detection rate of myocardial of male group were higher than female group;(2) Divided according to age<55,56-65years old,66to75years, age>75years old four groups. The coronary heart disease detection rate of the first three male groups were significantly higher than female groups (P<0.01). The coronary heart disease detection rates of these four different age groups were different either for male or for female. After the pairwise comparison, the first three male age groups gradually increased the detection rate of coronary heart disease, but the three age groups of women after detection of coronary artery disease were significantly higher than the first (P<0.008)(3) Female with single-vessel disease detection rate is45.40%, and35.70%for male; male with three-vessel disease detection rate is37.40%, and27.30%for female (P<0.01).The Gensini scores of male were significantly higher than female (P<0.05) in all the four different age groups;(4) Univariate analysis male of CHD group the age, hypertension, diabetes, high LDL-C, low HDL-C, smoking detection rate was significantly higher than non-CHD group (P<0.05), female of CHD group the age, hypertension, diabetes, high cholesterol, high LDL-C detection rate was significantly higher than non-CHD group (P<0.05).After comparing the male and female groups, we come to the results that the age, hypertension, diabetes, high cholesterol, high LDL-C detection rate of female CHD group were significantly higher than male group (P<0.05);(5) Logistic analysis showed that the most significant risk factors for CHD was diabetes, followed by smoking, low HDL-C, high LDL-C, aging, gender, but no significant was found in hypertension(P=0.10) and high cholesterol(P=0.29). Analysis by genders showed that smoking was the most significant risk factor for males, and diabetes was the most significant risk factors for female..Conclusions (1) Generally, the detection rate of coronary heart disease for male was higher than female. In male group the detection rate of coronary heart disease was increasing with aging more obviously, but in female group the detection rate of coronary heart disease was significantly increased after postmenopausal;(2) The severity of coronary artery disease was more severe in male patient than female patient;(3) The risk factors for coronary heart disease were different between male and female. The risk factors for male were mainly aging, hypertension, diabetes, high LDL-C, low HDL-C, smoking; the risk factors for female were mainly aging, hypertension, diabetes, high cholesterol, high LDL-C;(4) The coronary heart disease in female was later than in male, but the risk factors of hypertension, diabetes and high LDL-C affecting female more;(5) Diabetes was the most significant risk factor for coronary heart disease, followed by smoking, low HDL-C, high LDL-C, aging, gender;(6) Smoking was the most significant risk factor for male coronary heart disease patient. For female the most significant independent risk factor was diabetes.