Study Of The Relationship Between Blood Pressure And Severity Of Coronary Artery Disease

Objective:To study the relationship among aortic blood pressure, peripheral upper limb pressure and the severity of coronary artery stenosis. Methods:1. 283 patients who underwent coronary angiography due to suspected or diagnostic coronary artery disease were enrolled, of them 179 male and 104 female, age rang 32~82,mean age (59.07 ±10.45) years old. All subjects divided into two groups: 111 normotension(BP<140/90mmHg)and 172 hypertension. According to the num|ber of disease artery, thy were divied into 4 groups: 0 vessel, 1 vessel, 2 vessel, tripvessel.2. The severity of coronary artery lesions was evaluated by the number of disease arteries and Leaman' s coronary artery score (CAS). Aortic systolic blood pressure(SBP) and diastolic blood pressure(DBP) were measured during the period of coronary angiography. Peripheal blood pressure (brachial SBP and DBP)were measured before and after coronary angiography.3. Total cholesterol(TC), trigluceride(TG), high density lipoprotien(HDL), low density lipoprotien(LDL), fasting blood glucose(FBG) were measured, body mass index(BMI, Kg/m~2) and smoking index were calculated. 4. Mean value, t-test, ANOVA analysis, multifactor correlation and stepwise regression performed on all data by SPSS 11.5.Result:1. Aortic SBP were significant higher than peripheral SBP, aortic DBP were significant lower than peripheral DBP, aortic pulse pressure(PP) and pulsepressure index(PPI) were significant larger than peripheral PP and PPL2. There were significant differences between SBP, DBP, PP and PPI in hypertension and normotension groups. Hypertension group had a significant higher CAS than normotension group (24.87vsl4.68, p<005) . The percentage disease coronary arteries were significant different between two groups, hypertension group was higher than normotension ( x2=25.45, p<0.001) .3. Pearson correlation analysis indicated that blood pressure (aortic DBP,MBP,PP.PPI and brachial PP,PPI) were closely related to the CAS(r:-0.124-0.409, p< 0.05) .4. Multiple regression analysis indicated that aortic PPI( P =0.408, p=0.004), aortic PP( f3 =0.109, p=0.028), brachial PP (P =0.107, p=0.039)were closely related to the CAS .The other risk factors included age, gender, smoking, LDL, BMI, and EH.Conclusion:1. Peripheral systolic blood pressure were lower than aortic systolic blood pressure and higher than diastolic blood pressure. The difference of pulse pressure and PPI between aortic and peripheral were significant. Aortic blood pressure was more accurately than peripheral blood pressure.2. Hypertension is an independent risk factor of coronay artery disease. Patients with hypertension posses severer coronary arteries stenosis.3. PP and PPI are the markers of progression of arterial stiffness. Aortic PP, aortic PPI and peripheal PP are the independent risk factors of CAS. Furthermore, early diagnosis of coronary artery disease by PP, PPI and drug intervention maybe a useful therapy for coronary artery disease.