Correlation Between Ambulatory Arterial Atiffness Index,Plasma Atherosclerosis Index And Hypertension With Coronary Heart Disease

Objective: To investigate the correlation of Ambulatory Arterial Atiffness Index,Plasma Atherosclerosis Index and hypertension with coronary heart disease to know whether Ambulatory Arterial Atiffness Index,Plasma Atherosclerosis Index can be used as predictive indexes for coronary heart disease in patients with hypertension.Subjects and Methods of study:Hypertensive patients who were diagnosed with coronary heart disease and had coronary angiography,24-hour ambulatory blood pressure monitoring(ABPM),and laboratory tests for chest distress and chest pain were selected as the study subjects.According to the results of coronary angiography,they were divided into hypertension group and hypertension with coronary heart disease group.According to the lesions involving left main artery(LM),left anterior descending artery(LAD),left circumflex artery(LCX),and right coronary artery(RCA),the number of branches was divided into single-vessel disease group and multi-vessel disease group.SPSS20.0 software was used to carry out correlation data wilcoxon test,Kruskai-Wallis test,Bonferroni test,Spearman rank correlation analysis,Logistic regression model for correlation strength(OR,aOR and 95% CI)analysis,Fisher discriminant analysis,and application The tester's job characteristic curve(ROC)assesses the predictive value of AASI and AIP for hypertension with coronary heart disease,and uses the additive model and the multiplicative model to evaluate the interaction.Result:1.Comparison of serum lipids in hypertension with coronary heart disease group and hypertension group.The total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol-C(LDL-C)were higher in the hypertension with coronary heart disease group than in the hypertension group,and the difference was statistically significant(P<0.05).The high-density lipoprotein cholesterol(HDL-C)was lower in the hypertension with coronary heart disease group,the difference was statistically significant(P=0.015).2.Comparison of AASI in hypertension with coronary heart disease group and hypertension group.The AASI of the hypertension combined coronary heart disease group(0.49±0.21)was significantly higher than that of the hypertension group(0.44±0.17)(P<0.05),but the difference between the single-vessel disease group and the multi-vessel disease group was no statistical significance(P>0.05).3.Comparison of AIP in hypertension with coronary heart disease group and hypertension group.AIP in the hypertension with coronary heart disease group(0.13 ± 0.32)was higher than in the hypertension group(0.08 ± 0.41),the difference was statistically significant(P <0.05),but the difference between single-vessel disease group and multi-vessel disease group was no statistical significance(P>0.05).4.Correlation analysis4.1 AASI was positively correlated with age and 24 hPP.The Spearman's correlation coefficients were(r=0.128 P=0.049)and(r=0.0.218 P=0.001).There was no statistical significant correlation between AIP and sex,body mass index,24 h mean blood pressure,fasting blood glucose,uric acid,creatinine,smoking history,alcohol history,diabetes,total cholesterol,triglyceride,low density lipoprotein-C,high density lipoprotein cholesterol(P>0.05).4.2 AIP was positively correlated with body mass index and uric acid,and Spearman's correlation coefficients were(r=0.148 P=0.038)and(r=0.153 P=0.019).There was no statistical significant correlation between AIP and sex,smoking history,alcohol history,diabetes,24 h mean blood pressure,24 h mean pulse pressure,fasting blood glucose,creatinine,total cholesterol,LDL-C(P>0.05).4.3 Hypertension with coronary heart disease was positively correlated with gender,AASI,and AIP.Spearman's correlation coefficients were(r=0.171 P=0.009),(r=0.221 P=0.001),(r=0.128 P=0.019).age,smoking history,alcohol history,diabetes,24 h mean blood pressure,24 h average pulse pressure,fasting blood glucose,creatinine,total cholesterol,LDL-C were not significantly related(P>0.05).5.Logistic regression analysisGender,AIP,and AASI were risk factors for coronary heart disease in patients with hypertension.OR(95% CI)was 2.04(1.19 to 3.5),1.71(1.01 to 2.91),2.79(1.52 to 5.10),.But in age,body mass index,smoking history,alcohol history,diabetes,fasting blood glucose,uric acid,creatinine,and C-reactive protein there was no statistical significant difference(P>0.05).After controlling for risk factors such as gender,logistic regression analysis showed that hypertension with coronary heart disease were still associated with AIP and AASI,and aOR(95% CI)was 1.84(1.04 to 3.24)and 3.26(1.73 to 6.13).5.Interaction between AASI and AIPThe additive model and the multiplicative model were used to analyze the interaction between AASI and AIP.The results showed that there was a positive interaction between AASI and AIP in the hypertension with coronary heart disease group.The interaction indexes RERI,AP and S and its 95% CI were 5.55(-2.68-13.78),0.73(0.40-1.06),and6.18(1.01-35.05).Both interaction indexes AP and S showed a positive additive effect.But the multiplicative interactions did not show statistics.Significance.6.ROC curve and Fisher discriminant evaluation of the diagnostic value of AIP and AASIBased on the diagnosis of hypertension with coronary heart disease,the ROC curves for predicting coronary artery disease with AIP and AASI were performed.The area under the ROC curve of AASI and AIP was 0.618(95% CI 0.55 to 0.69,P=0.002),0.618(95% CI 0.53 to 0.68,P=0.038).Cross-validated(a)method was used to confirm the discriminant analysis of 235 subjects used in this study.The results showed that the correct classification of hypertension was 71.4%,29.7% was incorrectly diagnosed,and the correct classification of hypertension with coronary heart disease was 75.7%,24.3% was incorrectly diagnosed.Conclusion:1.AASI was related to age and 24 h average pulse pressure.With the increase of 24 h average pulse pressure AASI increased.AIP was associated with body mass index and serum uric acid.With the increase of body mass index and serum uric acid,AIP increased.2.AASI is associated with hypertension and coronary heart disease.With the increase of AASI,the risk of coronary heart disease increases.3.AIP is associated with hypertension and coronary heart disease.With the increase of AIP,the risk of coronary heart disease increases.4.AASI and AIP have no significant correlation with The severity of coronary artery disease5.AASI and AIP have an interaction effect on the diagnosis of coronary heart disease.The combined effect of AASI and AIP is greater than the sum of individual effects,suggesting that combined use of AASI and AIP can increase the diagnostic efficiency of coronary heart disease.