Analysis Of Risk Factors Between Male And Female Patients With Essential Hypertension

Objective:With the social development the incidence of hypertension showed a gradual upward trend, although we have made a lot of efforts, prevention and control of hypertension continues to be the focus of chronic disease and it is the top priority to reduce cardiovascular disease mortality. As a chronic systemic disease essential hypertension is caused by the interaction of genetic and environmental factors. A large number of domestic and international studies have shown that genetic background and bad habits are recognized as risk factors for essential hypertension, but studies on the differences of risk factors between the male and female patients are fewer. According to the different characteristics between the male and female patients the study is aimed to explore differences of the risk factors between them. It will provide the basis of prevention and treatment for essential hypertension.Methods:833(M307,F526) patients with essential hypertension were collected from the hypertension clinic in the affiliated hospital of Hebei North University. The name, sex, age, height, weight, waist circumference, systolic blood pressure, diastolic blood pressure and heart rate were measured and recorded. The body mass index (BMI) was calculated according to the height and body weight. The mean arterial pressure and pulse pressure were calculated according to the systolic blood pressure and diastolic blood pressure. The survey includes the respondents'life style, smoking history, drinking history, salt intake, fat intake, drug uses, history of chronic diseases, history of essential hypertension and family history of essential hypertension. The fasting blood serum potassium, serum sodium, glucose (GLU), triglyceride (TG), total cholesterol (CHOL), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA) and homocysteine (HCY) were measured through the hematology inspection. All cases were divided into two groups according to their gender. Differences of the blood pressure, environmental factors and genetic factors between the male and female patients were analyzed.Results:1 Blood pressureThe distribution of blood pressure levels between the male and female patients was significantly different (P<0.01). Levels of blood pressure and proportions showed that in the normal blood pressure group, the male group was higher than the female group. In the High-normal blood pressure group, the male group was lower than the female group. In the mild hypertension group, the moderate hypertension group and the serious hypertension group, the proportions of the male patients were higher than the female patients respectively. In the Isolated systolic hypertension group, the proportion of the male group was lower than the female group.On the whole, the diastolic blood pressure and the mean arterial pressure of the male group were higher than the female group respectively (P<0.05) and the pulse pressure of male group was smaller than the female group (P <0.05).While differences of the systolic blood pressure between the two groups were not statistically significant (P>0.05). In the young group, the systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure between the two groups showed no statistically significant differences respectively(P>0.05). In the middle aged group, the diastolic blood pressure of the male group was higher than the female group (P<0.05), and the pulse pressure of the male group was smaller than the female group (P <0.05).While the systolic blood pressure and the mean arterial pressure between the two groups showed no statistically significant differences respectively (P>0.05). In the old aged group, the diastolic blood pressure of the male group was higher than the female group (P<0.05). The systolic blood pressure and the pulse pressure of the male group were lower than the female group respectively (P<0.05).While the mean arterial blood pressure between the two groups showed no statistically significant differences (P>0.05).2 Environmental Factors2.1 General AnalysisIn the male group, the proportion of the obstructive sleep apnea syndrome (OSAS) was 66.8%, the proportion of smoking was 23.5% and the proportion of drinking was 21.2%. In the female group, the proportion of the obstructive sleep apnea syndrome (OSAS) was 56.3%, the proportion of smoking was 11.6% and the proportion of drinking was 11.0%. Proportions of the three items were significantly higher in the male group than the female group respectively (P<0.05).While comparisons of other baseline datas between the two groups had no statistically significant differences (P>0.05).2.2 Analysis of serum markersThe results showed that there were statistically significant differences on levels of HDL, Cr, UA and HCY between the male and female groups respectively (P<0.05). Compared with the female group, the male group showed a lower level of HDL.While levels of Cr, UA and HCY were higher in the male group than the female group respectively. Among other serological indicators there were no statistically significant differences between the two groups.3 Genetic factorsAll male and female patients were respectively divided into 4 groups: parents genetic group (group 1), paternal genetic group (group 2), maternal genetic group (group 3) and no family history genetic group (group 4). The proportions of 1-4 genetic groups in the male patients were 12.1%,16.9%, 24.4% and 46.6%, and the proportions of 1-4 genetic groups in the female patients were 11.2%,15.8%,27.6% and 45.4%. The Statistical test showed that Pearson x2=1.055, P= 0.788,P>0.05.The results indicated that there were no significant differences between the genetic distribution of the male and female patients with essential hypertension. The onset ages of the male patients without family history of essential hypertension were earlier than the female patients without family history of essential hypertension (P<0.05). The onset ages of the female patients with family history of essential hypertension were earlier than the female patients without family history of hypertension (P<0.05).The diastolic blood pressure of the male patients with family history of essential hypertension was higher than the female patients with family history of essential hypertension (P<0.05). And the diastolic blood pressure of the male patients without family history of essential hypertension was also higher than the female patients without family history of essential hypertension (P<0.05).The diastolic blood pressure of the female patients with family history of essential hypertension was higher than the female patients without family history of essential hypertension (P<0.05).4 Single factor analysis and binary Logistic regression analysis on the pulse pressure and influencing factors showed that the changes in levels of blood pressure were closely related to the male patients'pulse pressure. While the age and the levels of blood pressure were closely related to the female patients' pulse pressure.Conclusion:There exist some differences in environmental risk factors and genetic risk factors between the male and female patients with essential hypertension. Then we should pay more attention on these differences when we make some preventive measures and treatment for essential hypertension.