Study On Relationships Between The Carotid Artery Plaque In Patients With Primary Hypertension With Blood Pressure And Serum Homocysteine

Objective:To explore the relationships between the carotid artery plaque in patients with primary hypertension with blood pressure and serum homocysteine.Methods:The medical records of 126 patients with primary hypertension who were admitted to the cardiovascular department of internal medicine in the PLA Navy Anqing Hospital from August 2013 to August 2015 were retrospectively investigated and analyzed,who were carried out carotid ultrasound examination,and devided into normal carotid artery group,carotid artery thickening group and carotid artery plaque group according to the results of the examination.Then the blood pressure values and serum homocysteine levels were compared among the three groups.Then all patients were divided into occurrence group and non-occurrence group according to the occurrence of carotid plaques,and the single factor analysis and non-conditional Logistic regression analysis were performed to analyze the risk factors that may affect the occurrence of carotid plaque in patients with primary hypertension.The correlation coefficients of Intima-medial thickness and systolic blood pressure,diastolic blood pressure and serum homocysteine levels in patients with primary hypertension were determined by the linear correlation analysis method.Results:(1)Carotid artery ultrasound examination results showed that there were 42cases of carotid artery normal group,36 cases of carotid artery thickening group,48cases of carotid artery plaque group.There was no significant difference in gender among the three groups(P>0.05),and the differences were statistically significant in the baseline datas such as age,course of disease,hypertension staging and so on(P<0.05).(2)The differences were statistically significant in the level comparision of levels of systolic blood pressure,diastolic blood pressure and serum homocysteine among the three groups(P<0.05),among which the levels of the carotid artery thickening group and the carotid artery plaque group were significantly higher than those of the carotid artery normal group(P<0.05),and the levels of the carotid artery plaque group were significantly higher than those of the carotid artery thickening group(P<0.05).(3)There were significant differences in the factors such as age more than or equal to60 years old,stages of hypertension,abnormal glucose metabolism,family history of hypertension,history of stroke,course of disease more than or equal to 5 years,BMI more than or equal to 25kg/m~2,systolic blood pressure more than or equal to 160mmHg,diastolic blood pressure more than or equal to 100mmHg,serum homocysteine level more than or equal to 15?mol/L,low density lipoprotein more than or equal to4.14mmol/L,long-term use of statins lipid regulating drugs between the occurrence group and non-occurrence group(P<0.05),which had a certain relationship,and there were no significant differences in factors such as gender,smoking history,drinking history,serum uric acid more than or equal to 416?mol/L,serum creatinine more than or equal to 133?mol/L,triglyceride more than or equal to 2.27mmol/L,high density lipoprotein less than 1.04mmol/L,total cholesterol more than or equal to 6.19mmol/L,folic acid less than 5.21ng/mL,long-term use of diuretics between the two groups(P>0.05).(4)The risk factors of carotid artery plaque in patients with primary hypertension were ranked from high to low as follows:abnormal glucose metabolism(OR=19.971,P=0.005),low density lipoprotein(OR=3.258,P=0.017),course of disease(OR=1.601,P=0.013),serum homocysteine level(OR=1.421,P=0.011),diastolic blood pressure(OR=1.181,P=0.014)and systolic blood pressure(OR=1.097,P=0.024),and these factors were independent risk factors influencing the occurrence of such phenomena.(5)The severity of carotid artery plaque were positively correlated to SBP,DBP and serum homocysteine levels,of which the correlation coefficients were 0.617,0.632 and0.616,respectively.Conclusion:The incidence and severity of carotid plaque in patients with primary hypertension are related to the factors such as age,course of disease,stages of hypertension,abnormal glucose metabolism,family history of hypertension,stroke history,BMI,SBP,DBP,serum homocysteine level,low density lipoprotein and long-term use of statins lipid regulating drugs.The levels of serum homocysteine,diastolic blood pressure,systolic blood pressure,abnormal glucose metabolism,low density lipoprotein,and course of disease were independent risk factors.The IMT of carotid plaques and SBP,DBP,serum homocysteine levels have significant positive correlations,among which the blood pressure and serum homocysteine levels can be used important auxiliary indicators in the diagnosis and treatment effects assessment of patients with primary hypertension complicated with carotid plaques.