The Relationship Between Homocysteine And Carotid Atherosclerosis In Primary Hypertension Patients And The Effect Of Folacin

Objective:1.Taking Kunshan region as an example,the relationship between homocysteine and atherosclerosis in hypertensive patients was investigated,and whether homocysteine was an independent risk factor for atherosclerosis was confirmed.2.To investigate the effect of folacin on the level of homocysteine and the treatment of atherosclerosis.Methods: Selected 134 cases of primary hypertension patients from june 2014 to june 2015 in our cardiovascular department.Gender,age,smoking history,history of hypertension and other basic information were collected,Meanwhile,carotid ultrasound,homocysteine and other index were measured.The patients were divided into normal group 54 cases and 80 cases of carotid atherosclerosis group based on the results of carotid artery ultrasound.and homocysteine and other related indicators.Multi-factor Logistic regression analysis was performed to analyze diversity index of the two groups.The carotid atherosclerosis group of 54 high homocysteine cases were divided into two groups,both of which were given diet,life intervention,took atorvastatin calcium 20 mg qn and conventional antihypertensive treatment,.The experimental group took folic acid 0.8mg qd on the basis.During the treatment period,the liver function was examined once a month and other adverse drug reactions was paid attention.Observe changes of homocysteine and Intima-media thickness between the two groups after treatment for six months.Results:1.Age,systolic blood pressure,time history of high blood pressure,low density lipoprotein cholesterol,blood glucose,uric acid,homocysteine,smoking rates in carotid atherosclerosis group were higher than those in normal group,difference had statistical significance(P?0.05).multi-factor Logistic regression analysis revealed that Hcy was the independent risk factor of carotid atherosclerosis.2.Hcy concentrations were multiple plaques> twin plaques > single plaque group.The difference was statistically significant when comparing one to another(P<0.05).3.Before treatment,the levels of homocysteine in the experimental group and the control group were(18.4±10.8)?mol/L,(18.0±12.1)?mol/L,respectively.There was no statistical difference between the two groups(P>0.05).After treatment,the level of experimental group was(8±5.1)?mol/L,while that of the control group was(15.9±10.4)?mol/L,and there were significant differences between the two groups(P<0.05).The IMT of the two groups before treatment respectively were(1.30±0.24)and(1.31±0.33)without difference(P>0.05).after treatment,the experimental group IMT was(1.12±0.26),the control group was(1.25±0.44).The difference between the two groups was statistically significant(P<0.05).Duing treatment,one of the 54 patients showed a transient increase in transaminase,without interruption of treatment.Conclusions:1.Homocysteine is an independent risk factor of atherosclerosis.2.Homocysteine and the number of plaques were positively correlated.3.Folic acid can reduce the level of Hcy in patients with H type hypertension and may help block the damage of homocysteine on vascular endothelial cells,slow down and reverse the progression of atherosclerosis,and prevent cardiovascular and cerebrovascular diseases in patients with H type hypertension.