Analysis Of Pulse Wave Velocity In Essential Hypertension And Patients With Coronary Heart Disease

Background:Pulse wave velocity is currently regarded as a marker of the arterial stiffness. Research shows that PWV has important value of clinical application for disease risk stratification and prognosis on hypertension and coronary heart disease. The 2013 European guidelines for the management of arterial hypertension regarded the carotid femoral pulse wave velocity as an index for evaluating the target organ damage in patients with essential hypertension. Pulse wave velocity was influenced by some factors except for characters of artery, such as age, blood pressure, blood lipids and heart rates.Objective:To analysis the characteristics and influence factors of pulse wave velocity and the independent predictive value for coronary heart disease.Methods:A total of 201 patients were divided into four groups:normal group, hypertensive group(HP), coronary heart disease group(CHD) and coronary heart disease with hypertensive group(CHD+HP). All patients were underwent coronary angiography(CAG). Meanwhile, PWV were measured by invasive methods. Other baseline data, such as gender, age, height, weight and blood lip id, uric acid, creatinine and homocysteine were measured at the same time.Results:(1) There were significant differences in cfPWV and cdPWV among those four groups. CfPWV and cdPWV of those three groups were significantly higher than that normal group. There was no significant difference in crPWV among those four groups. (2)There was no significant difference in cfPWV and cdPWV between HP group an pure CHD group. CfPWV of CHD+HP group was significant higher than that HP group and CHD group(P<0.05). CdPWV of CHD+HP group and HP group was significant higher than that normal group. (3)There was significant difference in cfPWV、cdPWV and crPWV for within-group. (4)Muhiple stepwise linear regression analysis found that SBP, age, homocysteine and GIU were predisposed factors for cfPWV, while age, BUN and MAP were predisposed factors for cdPWV. (5)The cfPWV cutoff for detection of coronary heart was 9.6m/s, which had a sensitivity of 91.67% and a specificity of 46.15%.Conclusions:PWV was higher in patients with hypertension and coronary heart disease than that normal people. Vascular injury of patients with CHD complicated HP is significantly more severe than that HP and pure CHD. It has higher clinical value of cfPWV in daily practice. Systolic blood pressure, mean blood pressure, age, plasma homocysteinem, glucose and blood urea nitrogen were the influence factors of the pulse wave velocity.