The Correlational Study Between H-type Hypertension And Premature Coronary Heart Disease

Objective:To investigate the correlation between H-type hypertension and premature coronary heart disease, and provide new ideas for the prevention and treatment of premature coronary heart disease. Method:200 patients suspected premature coronary heart disease with hypertension in the Department of Cardiology of the first Affiliated Hospital of Nanhua University from January 2014 to January 2016, were enrolled in the study. They were divided into two groups According to their plasma homocysteine(Hcy) levels: H-type hypertension group( HHBP group, n=140)and hypertension group(HBP group,n=60).Make the recorded of age, sex and smoking history, diabetes history, blood lipid, uric acid, homocysteine and other clinical data and the results of coronary angiography. Compare the differences of general clinical data, the detection rate of premature coronary artery disease(PCHD) and the characteristics of coronary artery lesion between two groups. To compare the difference of Hcy level between different types of coronary heart disease and different coronary artery disease group in HHBP group. The multiple factor Logistic regression analysis was used to explore the risk factors of premature coronary heart disease. Result:1?There is statistical difference of Plasma Hcy level between HHBP group and HBP group(t=13.18,p<0.001),but There are no statistical differences of other clinical data,such as age, sex, smoking history, diabetes history, Family history of coronary heart disease,triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, uric acid between the two groups.(p>0.05).2?The detection rate of PCHD is 75% in HHBP group,while it is 55% in HBP group,and there is statistical difference of them(?2=7.21,p=0.007).The acute coronary syndrome(ACS) accounts for 76% of PCHD in HHBP group,while it is 55% in HBP group,and the difference is significant too(?2=7.21,p=0.007).3?The comparation of Coronary artery lesion characteristics:The single vessel, double vessel and triple vessel coronary artery lesions checked percentage of H-type hypertension group is 25.7%, 41.9%, 32.4%, while hypertension group is 69.7%, 21.2%, 9.1%, and the difference is statistically significant(?2=15.92, p < 0.001); comparation of Gensini score,and there is statistical difference between HHBP group 40(12,74)and HBP group12(6.5,21)(U=4.59,p<0.001).4?In H-type hypertension group, the levels of Hcy in stable angina group, unstable angina and acute myocardial infarction group are :13.20± 3.39, 16.25±5.90, 20.66±6.80umol/L, and the difference is statistically significant(F=14.73, p<0.001); The levels of Hcy in single, double and triple vessel coronary artery lesions are 14.47±4.45umol/L, 16.58±5.20umol/L, 18.50±5.61umol/L, and the differences are statistically significant too(F=12.92, p<0.001).5?Result of Logistic regression analysis suggest that H-type hypertension total cholesterol and smoking are independent risk factors of premature coronary heart disease.Conclusion:1?H-hypertension is closely related to the severity of coronary artery lesion of premature coronary heart disease, and Patients with premature coronary heart disease suffering from H-type hypertension in the same are more prone to acute coronary syndrome;2?H-type hypertension may be an independent risk factor of premature coronary heart disease.