Study On The Relationship Between H-type Hypertension And Acute Cerebral Infarction

Objective:In recent years,China's cardiovascular and cerebrovascular diseases increased year by year,of which cerebrovascular disease growth is more prominent.Epidemiological survey shows that compared with developed countries in Europe and America,China's stroke is more high incidence of heart disease,and Europe and the United States the incidence of heart disease is more prominent.For this,scholars survey found that high blood pressure in Europe and the United States people with hyperlipidemia,and our patients with high blood pressure in patients with high homocysteinemia,the proportion of up to 3/4,which may be China and European and American countries,the incidence of cardiovascular and cerebrovascular disease different reasons.China's hypertensive patients with homocysteine increased with the universal,for this reason,our scholars to highlight the relationship between the two,this situation is defined as H-type hypertension.Related studies have shown that H-type hypertension to promote the formation of acute cerebral infarction is much greater than the simple homocysteineemia or simple hypertension.This study examines the relationship between H-type hypertension and acute cerebral infarction in a number of ways,and describes its role in the formation of acute cerebral infarction and the relationship between them.Methods:Thirty-nine patients with ischemic stroke were divided into acute cerebral infarction group and transient ischemic attack group,Casecontrol studies were performed on both groups(The patients with acute cerebral infarction were treated with observation group and transient ischemic attack group).Collect the general condition of the patient(age,sex,past history,history of smoking and drinking).The assay(Homocysteine levels,low density lipoprotein,high density lipoprotein,total cholesterol,triglyceride)were recorded.According to the level of Hcy measured by high blood pressure and admission,the acute cerebral infarction and TIA group were divided into H-type hypertension group,simple hypertension group,simple homocysteine group,all normal group.Using SPSS13.0 statistical analysis software,single variable analysis do with t-test,X2-test,multiple variable analysis do with non-conditional logistic regression.Results:(1)The ischemic stroke was divided into male and female groups by sex,the incidence of H-type hypertension in men(57.36%)was significantly higher than that in females(45.08%),the difference was statistically significant.Male homocysteine levels(22.53±11.27)umol/L were significantly higher than female(13.50±8.07)umol/L.(2)The level of homocysteine in TIA group(17.29±11.88)umol/L was significantly lower than that in acute cerebral infarction group(20.34±10.30)umol/L.(3)Patients with acute cerebral infarction and TIA were divided into three subgroups of H-type hypertension,total hypertension,total homocysteine,the incidence of subgroups in both groups was total homocysteinemia> total H-type hypertension> total hypertension.The incidence of total hypertension was more in the acute cerebral infarction group(66.3%)than in the TIA group(56.1%),no significant difference(X2=3.453 P>0.05).The incidence of total H-type hypertension was significantly different(X2=14.143 P<0.05)in acute cerebral infarction group than in TIA group more in the acute cerebral infarction group(61.5%)than in the TIA group(40.2%).The incidence of total hyperhomocysteinemia was also significantly different(X2=17.232 P < 0.05),more the acute cerebral infarction group(91.4%)than the TIA group(74.2%).(4)The incidence of H-type hypertension in 115 cases of acute cerebral infarction group was 61.5%,which was significantly higher than that in TIA group(40.2%),the difference statistically significant(X2=14.143 P<0.05).For the incidence of hypertension alone,there were 21 cases(15.9%)in the TIA group,which was significantly higher than that in the acute cerebral infarction group(4.9%),the difference was statistically significant(X2 = 11.183 P <0.05).The incidence of Hcy in acute cerebral infarction group was 29.9%,slightly less than that in TIA group(34.1%),and there was no significant difference(statistically significant difference)(X2 = 0.614 P> 0.05).The acute cerebral infarction group was normal in 7 cases,the proportion of 3.7%,less than the TIA group(9.8%),with statistical difference(X2 = 4.908 P <0.05).(5)The order of incidence of four subgroups of acute cerebral infarction was H type hypertension(61.5%)> simple high Hcy(29.9%)> hypertensive(4.9%)> normal group(3.7%).There was no significant difference between the normal group and the simple hypertensive group(X2 = 0.261 P> 0.05).Simple high Hcy 56 cases,accounting for 29.9%,significantly higher than the normal group(X2=45.831 P<0.05)and simple hypertension group(X2=41.133 P<0.05).H-type hypertension totaling 115 cases,accounting for 61.5% of all cerebral infarction,significantly higher than the simple high Hcy(X2=37.505 P<0.05),simple hypertension(X2=135.557 P<0.05),normal(X2=141.892 P<0.05).(6)The acute cerebral infarction group was divided into H-type hypertension group and non-H-type hypertension group,H-type hypertension group total 115 cases,4 cases of normal intima,endometrial plaque formation in 111 cases.Non-H-type hypertension in 72 cases,13 cases of normal intimal,plaque formation in 59 cases,the incidence of carotid plaques(96.64%)in the hypertensive group was significantly higher than that in the non-H hypertensive group(81.94%).The incidence of recurrent cerebral infarction in H-type hypertension group was 49.56%,which was significantly higher than that in non-H-type hypertension group(26.397%).(7)According to the SSS score,four subgroups of acute cerebral infarction were divided into progressive stroke and nonprogressive stroke.The incidence of progressive stroke in four subgroups was H-type hypertension(46.96%)> high Hcy(26.79%)> Hypertension group(11.11%)> normal group(0%).There was no significant difference between the Hypertension group and the normal group.There was no significant difference between the HHcy group and the normal hypertensive group and the normal group.H-type hypertension were higher than the other three groups,there were statistical differences.(8)Multivariate analysis showed that H-type hypertension(OR=2.644),95.0%CI(1.297-5.390)and Hcy(OR=1.744),95.0%CI(1.047-2.903)were independent risk factors for acute cerebral infarction,and the regression coefficient ?(0.972)of H-type hypertension > Hcy(0.556).Conclusion:1.The incidence of H-type hypertension and homocysteine levels in men with ischemic stroke were higher than those in women.2.The level of homocysteine in patients with acute cerebral infarction was higher than that in TIA group.3.H-type hypertension may contribute to stroke progression and recurrent cerebral infarction.4.H-type hypertension in the high incidence of cerebral infarction,acute cerebral infarction may be an independent risk factor.5.Hypertension and hyperhomocysteinemia have synergistic effects on acute cerebral infarction.