Clinical Characteristic Of The Eldly Patients With H-type Hypertension

Objective: To compared the difference of clinical characteristics between eldly patients with H-type hypertension and the population with non-H-type hypertension,and improving the therapy of hypertension.Methods: This retrospective-sectional study used the hospitalized patients with hypertension in the First Affiliated Hospital of Guangxi Medical University,and all of their age was ?65 years.All of them were divided into two groups according to the plasma homocysteine(Hcy)concentration,H-type hypertension groups(plasma Hcy>15?mol/L)and non-H-type hypertension groups(plasma Hcy?15?mol/L).Analysis the difference of clinical characteristics in their sexy ratio,age,body mass index,systolic blood pressure(SBP),diastolic blood pressure(DBP),complications(cardiovascular diseases,stroke and diabetes mellitus),biochemical indicators including the levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein(LDL-c),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPBG),HbA1 c,K+,thyroid stimulating hormone(TSH),24 h urinary protein(24hU-pro),24 h urinary microalbumin(24hU-MALB).And comparing the degree ofventricular hypertrophy by their cardiac echocardiography including interventricular spetum thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(EF)and left ventricular mass(LVM),left ventricular mass index(LVMI).Result:A total of 224 cases were participated the study,aged 65 to 95 years,the average age was 74.32 ± 7.32,including 98 males and 126 females.They were divided into H-type hypertension groups(plasma Hcy>15?mol/L)and non-H-type hypertension groups(plasma Hcy?15?mol/L).The difference of body mass index,number of people drinking or smoking for two groups was insignificant(p>0.05).But it was different sex ratio as 52.4% was male in the H-type hypertension group and only 36.1% was male in the group with non-H-type hypertension,the statistically was significant(p<0.05).Morever,the systolic blood pressure(SBP)in the H-type hypertension group was higher than the population with non-H-type hypertension(p<0.05),but the diastolic blood pressure(DBP)was insignificant(p>0.05).The number of people with complications such as cardiovascular diseases and stroke in the H-type hypertension group was more than the population with non-H-type hypertension(p<0.05).The level of total cholesterol(TC),blood urea nitrogen(BUN),creatinine(Cr)and uric acid(UA)in the H-type hypertension group were higher(p<0.05).But the level of high density lipoprotein cholesterol(HDL-c)was lower in the H-type hypertension group(p < 0.05).The difference of triglyceride(TG),low density lipoprotein cholesterol(LDL-c),thyroid stimulating hormone(TSH),K + concentration,fasting blood glucose(FBG),2 hours postprandial blood glucose(2hPBG),Hb A1 c,24h-Urinary protein(24hU-pro)and 24 h Urinary microalbumin(24hU-MALB)wereinsignificant(p>0.05).The left ventricular mass index(LVMI)and the number of left ventricular hypertrophy(LVH)in the H-type hypertension group were more than the population with non-H-type hypertension(p<0.05).Conclusion: The eldly patients with H-type hypertension had a higher average age and a greater proportion of male.The chance of complications included cardiovascular diseases,stroke,renal dysfunction and left ventricular hypertrophy were more than the population with non-H-type hypertension.The blood biochemical indicators and other metabolic abnormalities occurred more obvious.The study reveals that the prognosis of elderly patients with H-type hypertension is worse.