Cases Analysis Of Carotid Atherosclerosis In Patients With H Type Hypertension

Objective：Compared plasma homocysteine level in H type hypertension withsimple hypertension, by carotid ultrasound to evaluate the patients’ carotid arterialstructure changes of H type hypertension and simple hypertension, analysis thecarotid atherosclerosis risk factors of H type hypertension. Discussion on H typehypertension in accelerating the process of atherosclerosis, as to provide referencefor clinical treatment of hypertension and provide a basis for prevention andtreatment of atherosclerotic cardiovascular and cerebrovascular diseases.Methodology：Selected430cases of patients with essential hypertension from May2013to May2014in the Center Hospital Affiliated to Shenyang Medical College,whose age from25to75. According to the plasma homocysteine level, divided intosimple hypertension group(essential hypertension,plasma homocysteine＜10μmol/L)and H type hypertension group(essential hypertension,plasma homocysteine≥10μmol/L). Recorded the patients’ age, gender, smoking history, height, weight,duration of hypertension, blood pressure, blood glucose,blood lipids, blood uric acid,plasma homocysteine level, the carotid intima-media thickness, carotidatherosclerotic plaques and the condition of carotid stenosis.Input data by Excel andstatistical analysis by SPSS17.0. Count data were compared by chi-square test orFisher probabilities, and measurement data were compared by t test and rank test.Results：1. H type hypertension and plasma homocysteine levelPlasma homocysteine level in patients with H type hypertension group wereobviously higher than simple hypertension group.2. H type hypertension and the formation of carotid atherosclerosisCarotid atherosclerosis in patients with H type hypertension group wasobviously higher than simple hypertension group.3. Related factors of H type hypertension and carotid atherosclerosis (1)The H type hypertension patients of60years old or older in the detectionrate of the carotid intima-media thickening,plaque formation,unstable plaque,carotidstenosis>50%and intima-media thickness,the plaque number,the average diameterof plaque were significantly higher than those of less than60years old group.(2)The male patients with H type hypertension in the detection rate of unstableplaque and carotid stenosis>50%were significantly higher than the female patients.(3)The H type hypertension patients with smoking history more than or equal to5years in the detection rate of the carotid intima-media thickening,plaqueformation,unstable plaque,carotid stenosis>50%and intima-media thickness, theplaque number, the average diameter of plaque were significantly higher than thosewith smoking history less than5years group.(4)The H type hypertension patients of duration of hypertension more than5years in the detection rate of plaque formation,unstable plaque,carotid stenosis>50%and intima-media thickness, the plaque number, the average diameter of plaque weresignificantly higher than those of duration of hypertension1to5years group.(5) The H type hypertension patients of body mass index more than or equal to24in the detection rate of the carotid intima-media thickening,plaqueformation,unstable plaque,carotid stenosis>50%and intima-media thickness, theplaque number, the average diameter of plaque were significantly higher than thoseless than24group.(6) The H type hypertension patients of high triglyceride lipids in the detectionrate of the carotid intima-media thickening,plaque formation,unstable plaque andintima-media thickness, the plaque number, the average diameter of plaque weresignificantly higher than those normal group.The intima-media thickness of the H type hypertension patients withhypercholesterolemia were significantly higher than those normal group.The H type hypertension patients with High LDL-C hyperlipidemia in thedetection rate of carotid stenosis>50%and intima-media thickness weresignificantly higher than those normal group.The H type hypertension patients with Low HDL-C hyperlipidemia in thedetection rate of unstable plaque and carotid stenosis>50%were significantly higherthan those normal group.(7)The H type hypertension patients with abnormal blood uric acid in the detection rate of the carotid intima-media thickening,unstable plaque,carotidstenosis>50%and intima-media thickness, the plaque number, the average diameterof plaque were significantly higher than those normal group.Conclusion：1. The risk of carotid atherosclerosis in patients with H type hypertension is moreserious than simple hypertension.2. Plasma homocysteine level of more than10μmol/L is an important risk factorof carotid atherosclerosis in essential hypertension patients.Increasingage, male, long-term hypertension history, long history of smoking, overweight orobesity, hyperuricemia, hyperlipidemia especially high triglyceride lipids wererelated with occurrence and progression on carotid atherosclerosis in H typehypertensive patients.