| Objective: hypertension is not only the most common cardiovascular disease in elderly patients, but also an important risk factor for stroke and ischemic heart disease. Previous studies show that pre-thrombotic state(PTS) in elderly patients with hypertension is one of the reasons for hypertension becoming the important risk factor for the diseases mentioned above. Nonetheless, in elderly patients with hypertension, what is the incidence of PTS as a pathological process related with hemostasis, coagulation, imbalance of anticoagulant or fibrinolytic system? Is there a relationship between blood pressure variability and PTS? Do the testing methods for coagulation function, such as routine coagulation test, platelets, and thromboelastography, accurately reflect the forming of PTS? A series of problems has been unclear right now. In this study, we analyzed the features of coagulation markers in elderly patients with hypertension through multiple testing methods and the relationship between blood pressure variability and PTS and investigated the application value of the testing methods for coagulation function in the diagnosis of PTS, such as routine coagulation test, platelets, and thromboelastography. The results may provide theoretical basis and objective evidence for clinical early diagnosis of PTS and prevention of hypertension complications.Methods: 247 elderly patients aged more than 80 who were admitted to the geriatric department of our hospital from August 2014 to March 2016 were included. Among the participants, there were 163 patients with hypertension diagnosed in accord with the diagnostic criteria published in the 2010 version of Chinese Guidelines on Prevention and Control of hypertension and 84 patients with normal blood pressure who served as control group. The participants were divided into hypertension group and normal control group according to the case data searched by Haitai 3.0 system and their medical history data. An analysis was performed using SPSS 19.0 software. A comparison of baseline data, blood pressure variability, blood routine test, routine coagulation test, and thromboelastography was conducted between the two groups. And a partial correlation analysis between blood pressure variability and fibrinogen, R value, K value, Angle value, MA value, and CI value. Continuous data were described with x+s and their comparison between the two groups was made by t test. Categorical data were expressed with case number and their comparison between the two groups was made by chi-square test. P < 0.05 was considered as statistically significant.Results:1. A comparison of baseline data between the hypertension group and the control group showed that there was no significant differences in age, gender, body mass index, smoking history, triglyceride, cholesterol, low-density lipoprotein, blood sugar, urea nitrogen, and creatinine(P>0.05).2. Daytime, nighttime, and 24-hour systolic blood pressure variability and nighttime diastolic blood pressure variability in the hypertension group were significantly higher than those in the control group.3. As for each coagulation marker, compared with the control group, the hypertension group had significant higher fibrinogen, Angle value, MA value, and CI value and significant decreased R value and K value. No significant differences were seen in platelet count, APTT, PT, INR, TT, LY30.4. The partial correlation analysis between blood pressure variability and fibrinogen, R value, K value, Angle value, MA value, and CI value showed that 24-hour SBPV and nighttime DBPV in the hypertension group was significantly correlated with MA value(respectively, r=0.416, P<0.05;r=0.423,P<0.05).Conclusion:1. The blood pressure variability in the elderly patients with hypertension is higher than that in the cases with normal blood pressure.2. The blood pressure variability in elderly patients with hypertension is significantly related with the intensity of blood clot, so it is one of the risk factors for the formation of PTS.3. Compared with routine coagulation test and platelet count, thromboelastography can reflect the coagulation state of elderly hypertension patients more accurately, which has more comprehensive guiding significance for assessment, diagnosis and treatment of clinical PTS. |
