Correlation Between Apo B/Apo A1 Ratio And Target Organ Damage In Elderly Patients With Essential Hypertension

Under the background of population aging,chronic diseases have become a major public health problem threatening people’s health and quality of life.The "healthy China 2030" planning outline,points out that construction of China’s fundamental purpose is to achieve universal health health,insist on focusing on grass-roots,built completely integrated medical and health service system,and the grading system is the foundation of implementing integrated medical and health services,management and hierarchical diagnosis and treatment of chronic diseases and promote breakthrough.Hypertension is a chronic progressive disease that increases with age.More than 50% of the elderly suffer from hypertension,which is an important risk factor for secondary coronary heart disease,stroke and even cardiovascular and cerebrovascular death.At present,the important index to evaluate the prognosis of hypertension is the target organ damage of hypertension,and the commonly used examination methods include: head CT/MRI,coronary angiography/coronary CTA,cardiac/cervical vascular ultrasound,etc.But they can only indicate a system of disease,and the cost of examination is expensive,difficult to promote the application at the grassroots.Therefore,in the grass-roots clinical work,it is urgent to use the relatively simple,economical and easy to promote the examination method screening hypertension target organ damage early intervention.At present,atherosclerotic cardiovascular disease caused by dyslipidemia,arteriosclerosis,and atherosclerosis is still an important risk factor for the health of the people.Studies have found that apolipoprotein can reflect the utilization and metabolism of blood lipids,and gene mutations can occur to cause abnormal blood lipids.Among the different types of apolipoproteins discovered to date,apolipoprotein B is a risk factor for atherosclerosis,and apolipoprotein A1 has an antagonistic effect.the ratio of apolipoprotein B / A1 can indicate the trend of atherosclerosis in plasma.Therefore,the apolipoprotein B / A1 ratio may indicate the occurrence of dyslipidemia,atherosclerosis,and atherosclerotic cardiovascular disease.In the current clinical testing work,Apolipoprotein B and Apolipoprotein A1 have the advantages of being relatively simple,cheap,and easy to promote,and can be measured at any time without fasting,and their expression is not affected by oral lipid-lowering drugs.Hypertensive target organ damage includes: coronary heart disease,stroke,renal function damage,atherosclerosis,fundus retinopathy and other pathological damage to organs.The pathophysiological mechanism of the formation of related diseases is closely related to atherosclerosis,atherosclerosis,dyslipidemia,etc.The related representative diseases are consistent with atherosclerotic cardiovascular diseases.However,whether the target organ damage in hypertension is related to the apolipoprotein B / A1 ratio is unclear.Therefore,this clinical study analyzed the relationship between the apolipoprotein B / A1 ratio and target organ damage in elderly patients with essential hypertension from multiple levels of analysis,and discussed the apolipoprotein B / A1 ratio and target organs in elderly essential hypertension Correlation of damage.It provides a simpler and easier detection method for prompting target organ damage in elderly patients with essential hypertension.Objective:The ratio of apolipoprotein B / A1 in elderly patients with essential hypertension combined with any target organ damage and elderly patients with simple essential hypertension was compared.Multi-level analysis to study the relationship between apolipoprotein B / A1 ratio and target organ damage in elderly patients with essential hypertension.It provides a simpler and easier detection method for prompting target organ damage in elderly patients with essential hypertension.Methods:1.A retrospective analysis of 213 elderly patients with primary hypertension(≥ 65 years old)hospitalized in Huaihe Hospital of Henan University from October 2018 to October 2019,with complete medical records.According to the presence or absence of any target organ damage,it is divided into two groups: Group A: elderly essential hypertension,accompanied by any target organ damage;Group B:simple elderly essential hypertension.2.Data collection: record age,course of hypertension,height,weight,take venous blood to measure HCY,UA,CYC,TG,TC,LDL,HDL,Apo A1,Apo B,Lp PLA2,and calculate the apolipoprotein B/A1 ratio and BMI.3.All the data after proofreading were entered into the computer,and SPSS 25.0 software was used for statistical analysis.The difference of P value <0.05 was statistically significant.Result:1.Comparison of general information between the two groups:The age level of group A is higher than that of group B,P=0.047<0.05,which is statistically significant.It is a risk factor for target organ damage in elderly essential hypertension.The duration of hypertension in group A is higher than that in group B,P=0.024<0.05,which is statistically significant.It is a risk factor for target organ damage in elderly essential hypertension.There is no statistical significance in gender and BMI between the two groups(P>0.05).2.Comparison of blood biochemical indexes between the two groups:The HCY,UA,LDL,Apo B,Apo B/Apo A1 ratio,and Lp PLA2 levels of group A are higher than those in group B,which are statistically significant(P<0.05),and are risk factors for target organ damage in elderly essential hypertension.The levels of Apo A1 and HDL in group A are lower than those in group B,which are statistically significant(P<0.05),and they are protective factors for target organ damage for target organ damage in elderly essential hypertension.TG and TC between the two groups are not statistically significant(P>0.05).3.Single factor Logistic regression analysis:HCY,UA,Apo B,Apo B/Apo A1 ratio and Lp PLA2 are risk factors for target organ damage in elderly essential hypertension(P<0.05).Apo A1 is a protective factor for target organ damage in elderly essential hypertension(P<0.05);The duration of hypertension,HDL,LDL are not risk factors for target organ damage in elderly essential hypertension(P>0.05).4.The ratio of Apo B/Apo A1 was analyzed by using the jorden index method:The area under the curve AUC=0.72,P<0.001,which is statistically significant,the corresponding sensitivity is 71.90%,the specificity is 66.67%,and the critical value corresponding to the maximum Youden index is 0.5774.That is,when Apo B/Apo A1 is greater than 0.5774,target organ damage may occur in elderly essential hypertension.Conclusion:1.Apo A1 is a protective factor for target organ damage in elderly essential hypertension.2.Apo B,Apo B/Apo A1 ratio,Lp PLA2,HCY,UA are risk factors for target organ damage in elderly essential hypertension.3.The Apo B/Apo A1 ratio can predict the risk of target organ damage in elderly patients with essential hypertension.When the Apo B/Apo A1 ratio in elderly patients with essential hypertension is greater than 0.5774,target organ damage in hypertension is likely to occur.