The Investigation And Study Of Cardiovascular Risk In Middle-aged And Elderly Patients With Essential Hypertension

Purpose:To understand the proportion, type and degree of the middle-aged and elderly essential hypertension with cardiovascular risk factors, target organ damage, clinical complications.Respectively to compare the cardiovascular risk of different ages, different gender and different levels.To provide a basis for the prevention and comprehensive treatment of middle-aged and elderly patients with essential hypertension.Methods:Investigate of 802 patients with more complete information in the outpatient of First Affiliated Hospital of Kunming Medical University from March 2013 to March 2015. Everyone is 45 to 90 years old. The average age 64.09±10.07. Including45～59 years old (average age 54.02±4.07) of middle age group of 282 people, and over 60 years old (average age 69.55±7.92) the elderly group of 520 people.The survey included:Gender, age, contact information, height, weight, waist circumference (WC), heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking status, hypertension, blood pressure levels, family history, cerebrovascular disease, heart disease, kidney disease, peripheral vascular disease, diabetes, and retinopathy; collect the serum total cholesterol(TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low densitylipoprotein cholesterol (LDL-C), fasting blood glucose (FBG),2 hour postprandial blood glucose (2hPBG), serum creatinine (Scr), homocysteine (Hcy), electrocardiogram,echocardiography, carotid artery ultrasound, carotid femoral pulse wave velocity, ankle/brachial blood pressure index, urinary albumin, albumin creatinine ratio, cranialcomputed tomography (CT) or magnetic resonance imaging (MRI). To compare patients with essential hypertension between middle and elderly, different gender, different levels. And to assess the risks of the essential hypertension.Result:1. Compared between middle-aged group and the elderly group:the abdominal obesity or obesity of middle-aged group were higher than that of the elderly group(P<0.05). In addition to abdominal obesity or obesity, dyslipidemia, smoking, IGT or IFG,familyhistory of premature cardiovascular disease were not statistically significant (P>0.05).In addition to retinopathy, the target organ damage, clinical complications of eldly group were higher than that of middle-aged group (P<0.01 or P<0.05).2. Compared between male and female:the proportion of age factor and smoking, in male patients is higher than those of female patients, the difference was significant statistically significant(p<0.01). The proportion of abdominal obesity or obese in male patients is higher than those of female patients, the difference was statistically significant(p<0.05). The proportion of cardiovascular disease family history in female patients is higher than those of male patients(p<0.01). The dyslipidemia, IGT or IFG had no significant difference between male and female. The proportion of target organ damage in male patients is higher than those of female patients(p<0.01). The proportion of heart disease, kidney disease, diabetes in male patients is higher than those of female patients, The difference was statistically significant (p<0.01 or p<0.05).3. All levels of essential hypertension:age and blood pressure levels were positively correlated(p<0.01). Except the factor of age, there was no significant difference between the various cardiovascular risk factors (p>0.05). With the increase of the level of hypertension, target organ damage and clinical complications increased. Cerebrovascular, heart disease, kidney disease, retinopathy were statistically significant (p<0.05 or p<0.01). Vascular diseases and diabetes had no significant difference(p>0.05).4. General analysis showed that:the middle-aged and elderly with essential hypertension associated with multiple cardiovascular risk factors, high proportion of target organ damage and clinical complications.Essential hypertension in high-risk, very-high-risk were more common. The elderly group is extremely high risk ratio is higher than the middle age group(p<0.01).The elderly group composed of high-risk ratio is higher than the share of middle-aged group(p<0.01). The elderly group combining at least three other cardiovascular risk factors is higher than the middle-aged group.(p<0.05).The male composed of high-risk ratio is higher than the share of female group(p<0.01). The male group combining at least three other cardiovascular risk factors is higher than the female group.(p<0.05).With the increase of the level of hypertension, very-high-risk ratio accounted for the proportion increased(p<0.01).At all levels of high blood pressure and other cardiovascular risk factors was no statistically significant difference (p>0.05).Conclusion:1. More middle-aged and elderly essential hypertension with abdominal obesity or obesity. They should pay attention to weight control and exercise. The target organ damage, clinical complications of elderly group were higher than that of middle-aged group, prompt that the elderly patients with essential hypertension with higher cardiovascular risk.2.The number of male smoking and abdominal obesity or obesity is more than female. They should pay attention to give up smoking, weight control and exercise, improve the way of life.The proportion of target organ damage, clinical complications and cardiovascular risk in male patients is higher than that of female patients. Male patients with higher cardiovascular risk.The number of female patients with a family history of premature cardiovascular disease is more than male. Consider the relationship in genetic factors,the female is more closely than male patients,the mechanism remains to be further research.3. Age and blood pressure levels were positively correlated.With the increase of the level of hypertension, target organ damage and clinical complications accounted for the proportion increased, it prompts with the increased blood pressure, cardiovascular risk increased.4.The middle-aged and elderly with essential hypertension associated with multiple cardiovascular risk factors, high proportion of target organ damage and clinical complications.Essential hypertension in high-risk, very-high-risk were more common.We should positive control of blood pressure, ant the same time, according to the different cardiovascular risk of different ages, different gender and different levels, we should pay attention to comprehensive prevention and treatment in order to reduce the happening of cardiovascular events and death.