The Correlation Between Pulse Pressure Index Of Hypertension And Degree Of Coronary Artery Disease

Objective: Investigate The correlation between the PPI of hypertension and.the Degreeof coronary artery disease;Method: From May2012to February2014, Select107(60males,47females, Theaverage age (57.54±11.15) years old)cases of patients with essential hypertensionWhile patients with suspected coronary heart disease from the Affiliated Hospital ofYan’an University as the Observer Group, At the same time Select56(33males,23females, The average age57.16±9.88years old)cases of patients with suspected coronaryheart disease and normal blood pressure as the Control group. Collect and record the Riskfactors of Coronary heart disease such as all patients, Gender, age, activity, Smokingstatus, Type2diabetes mellitus and Family history of coronary heart disease In the firstdays after hospitalization. Measure Their Height, weight. And compute the Body massindex(BMI). The next day Exsanguinate and assay the Biochemical indicators such asTriglyceride（TG)、Low-lipid lipoprotein，(LDL)、Blood uric acid（BUA）、High-densitylipoproteins（HDL)、Hasting blood glucose（FBG）、Total cholesterol(TC). Be fore theSurgery, all Patients need24-hour ambulatory blood pressure monitoring, and thenrecord Diastolic blood pressure (DBP)、Systolic blood pressure(SBP），next computePulse pressure(PP)and Pulse pressure index (PPI)，Hereafter do the Selective coronaryangiography by the Judkins method.Analyze the severity of coronary artery disease.Andit is represented by the number of Have coronary artery disease artery and coronaryartery score(CAS）on Gensini integration,next compute the coronary artery stenosis byvisual diameter law.If Greater Stenosis and (or) equal to50%any of Left anteriordescending(LAD）、Left circumflex(LCX)and Right coronary artery(RCA）is greaterstenosis or equal to50%, We regard it to meaningful lesions.（Note：If the same branch are different in different parts of the vascular stenosis, then the most important part of acoronary artery stenosis to determine the basis for meaningful disease），For LeftMain(LM) Lesions, Whether does LAD、LCX lesions, We put them to double vesseldisease. If concomitant right coronary artery lesions are classified as three diseasegroups.PPI and related risk factors for coronary heart disease that may affect the resultsof coronary angiography univariate correlation analysis， The results of coronaryangiography were to have coronary heart disease is the case whether the dependentvariable, and severity of coronary Gensini scores were correlated with factors BinaryLogistic regression analysis as independent variables.Optional SPSS20.0statistical analysis software package for data processing,With amean+standard deviation(x±s),to represent the data measured data, Perform KStest,normal distribution,With two independent samples t test was used to compare twosample;With a sample rate of said two count data,Disorder classification data werecompared with x2test，Among groups were compared using ANOVA, First with Levenemethod for multiple sets of data between the homogeneity of variance test,heterogeneityof variance has been corrected,further pairwise comparisons using LSD method;Betweentwo continuous variables were analyzed using Pearson correlation method,Correlationanalysis of ordered categorical variables using Spearman correlation,Scatter plots aredrawn,P <0.05was considered statistically significant;All relevant factors analyzed bythe two groups were further analyzed Binary Logistic Regression.Result:1.By Comparing hypertensive group and non-hypertensive group, The resultsshow: Differences between the two groups of patients，Age、Sex ratio、Diabetes、BMI、TG、TC、FBG、Smoking history、 history of alcohol abuse、 activity history、 familyhistory have no statistical meaning（P>0.05）.But Differences between the two groups ofpatients，SBP、DBP、PP、PPI、LDL-C、HDL-C、BUA have statistical meaning（P<0.05）.and hypertensive group is higher than non-hypertensive group, especially thedifferences on the SBP、DBP、PP、PPI（P<0.01）.2. The detection rate of coronary heart disease on observer group is significantly higher than the control group,the difference was statistically significant (x2=16. 410，P<0.01).3. Differences between the two groups of patients，PPI、Lesion count havestatistical meaning P<0.01）.The more lesion count, the higher the PPI value; Accordingto the data shows the PPI of the coronary artery disease patients were higher than the PPIof the Normal coronary group, the PPI of three lesions group is significantly higher thanthe PPI of single lesions group,it has statistical meaning (P<0.01).In the control groupbetween adjacent coronary artery disease count PPI was no significant difference (P>0.05), but there is an increasing tendency of PPI value. Grouped according to the numberof coronary lesions visible results, when the same number of coronary lesions, PPI higherin the observation group, the difference was statistically significant (P <0.01).4.Groups in all patients with coronary heart disease, hypertension group,s PPI andcoronary artery disease severity Gensini scores were significantly higher thannon-hypertensive group, the difference was statistically significant,(p <0.01).5. PPI、PP、SBP、DBP of them are Correlated with Gensini score(P<0.05). Inaddition, LDL、HDL and BUA of them are Correlated with Gensini score,especially PPI（P<0.001）; Two groups of patients were not correlated with the rest of the factors.Inaddition to all incoming patients as a whole, the factors associated with the PPI andpartial correlation analysis available, PPI and PP and SBP was a significant positivecorrelation (r1=0.930, P<0.01; r2=0.643, P <0.01), and DBP was negatively correlated(r3=-0.387, P <0.01).6. Regression analysis shows:as LDL、BUA、SBP、DBP、PP、PPI、HDL to theindependent variables,while as Coronary heart disease to the dependent variable, analyzeand count the data by Two classification Logistic. By multivariate regression analysisshowed that: LDL-C、SBP、DBP、PP、PPI are independent risk factors of Coronary heartdisease, especially PPI（P<0.001）,but the BUA is not independent risk factor.Conclusion:1.PPI is closely related to the degree of coronary artery disease in patientswith coronary heart disease,PPI and coronary artery lesions and Gensini scores werepositively correlated measurement. PPI help predict severity of coronary artery disease inpatients with coronary artery disease. 2.PPI is the development of CHD in patients with hypertension is an importantindependent predictor. PPI for normal blood pressure but the severity of coronary arterylesions of CHD patients also have good predictive value.3. PPI is an effective predictor of coronary artery disease pressure levels in patientswith coronary heart disease, coronary heart disease in the early stages of its activeintervention can delay the progress of coronary artery disease.More likely early coronaryheart disease is expected to be reversed, so the buck, while the value of positiveobservations PPI prevention of CHD may play a significant clinical effect.