Evaluation Of Multiple Risk Factors For Cardiovascular Disease In Patients With Hypertension

Objective:To evaluate levels and relationship of classical and new risk factors (high sensitivity C-reactive protein, adiponectin and homocysteine) in patients with hypertension, to explore the change of new markers when ACS happened and the predict valuation of them for ACS in patients with hypertension.Methods:The study population consisted of confirmly diagnosed hypertension patients with ACS, hypertension patients without other cardiocerebral or peripheral vascular diseases and health people was divided into A, B and C three groups, then to compare general data and levels of new risk factors of three groups, analyse the change of all measurements in hypertension patients and hypertension patients with ACS. To study the measurements affecting new risk factors and incidence of ACS, tier hs-CRP levels and explore different hs-CRP risk stratifications effect on incidence of ACS in patients with hypertension.Results:The number of smokers, body mass index, blood pressure, lipid, glucose, uric acid, fibrinogen, hemoglobin, white blood cell count,ICVD risk scores, hs-CRP, ADP and Hey of three groups had statistically difference (P＜0.05). The level of new risk factor hs-CRP in group A was higher than group B, the level of ADP in group A was lower than group B, the difference had statistical significance (P＜0.05).The correlation and regression analysis of new risk factors and other indicators in patients with hypertension indicated that white blood cell count and fibrinogen were the factors which affected serum hs-CRP level, regression equation was Y (hs-CRP)=-5.384+0.575X(white blood cell count)+1.222X(fibrinogen), Hey was the factors affected serum ADP level, regression equation was Y (ADP)=2.333-0.018X (Hey), uric acid,ADP, creatinine and smoke affected serum Hey level, regression equation was Y(Hcy)=11.293+0.016X(uric acid)-1.702X(ADP)+0.041X (creatinine)+1.506X(smoke).The regression analysis of measurements and whether merge ACS in patients with hypertension indicated that HDL, hs-CRP and ADP were the factors affected the incidence of ACS, regression equation was Y (incidence of ACS)=3.127-1.945X (HDL)+0.190X (hs-CRP)-0.894X (ADP).hs-CRP levels of hypertension patients was divided into low risk (＜1mg/L), moderate risk (1-3mg/L) and high risk (>3mg/L) three groups, ratio of patients with ACS in high risk group was higher than other two groups obviously, the difference had statistical significance (P＜0.05).Conclusion:1. Body mass index, blood pressure, lipid, glucose, fibrinogen, hs-CRP, Hcy and ICVD risk scores (10years) of hypertension patients without other vascular diseases were higher than normal people, ADP level was lower than normal people.2. New risk factor hs-CRP level in hypertension patients with ACS was higher than hypertension patients without other vascular diseases, ADP level in hypertension patients with ACS was lower than hypertension patients without other vascular diseases. Besides traditional risk factors, hs-CRP and ADP levels changed obviously when ACS happened in patients with hypertension, which related with acute cardiovascular event closely. Stratified hs-CRP level in patients with hypertension, the result showed the risk of ACS ascended sharply in hypertension patients that hs-CRP>3mg/L.3. ADP and Hcy levels in hypertension patients had evident negative correlation. Compared with normal people, serum Hcy level of hypertension patients elevated overall. The difference of Hey levels in hypertension patients with ACS and hypertension patients without other vascular diseases had no statistical significance, but Hcy level in hypertension patients with ACS had an ascending trend. Hs-CRP, ADP and Hcy were the new markers and forecast of acute cardiovascular events such as ACS, they played the aggravating role from hypertension to ACS.