To Investigate The Effect Of Different Concentrations Of Hcy On The Severity Of Coronary Artery Disease In Patients With H-type-hypertension

Objectives:To investigate the effect of different concentrations of Hey on the severity of coronary artery disease in patients with H-type-hypertension.Methods:200 cases of patients in department of Cardiology with primary hypertension were selected from March 1st,2016 to October 31st,2017 as subjects in the study.Record plasma homocysteine,fasting plasma glucose,lipids,renal function,myocardial enzyme spectrum and amino terminal B-type brain natriuretic peptidein in each group,and record general information such as sex,age,admission blood pressure,smoking history,and family history of coronary heart disease in each group.According to the plasma homocysteine level,150 cases of patients with essential hypertension with plasma Hcy≥10umol/L were selected,of which 10umol/1≤Hcy<20umol/1 was marked as group H1(50cases),20umol/1≤Hcy<3 0umol/1 was labeled as group H2(50cases),Hcy≥30umol/1 was labeled as group H3(50 cases),and simultaneously selected as simple primary hypertension patients Hcy<10umol/L(50 cases)were marked as HO group.Coronary heart disease(CHD)was diagnosed by coronary angiography and the incidence of coronary heart disease was statistically compared between different Hcy concentrations.After eliminating non-CHD patients,the proportion of acute coronary syndromes(ACS)in each group was statistically compared according to the eighth edition of diagnostic criteria for internal coronary artery disease.Finally,according to the results of coronary angiography,the number and proportion of coronary lesions with single-vessel disease,double-vessel disease,and multi-vessel disease were statistically compared.Gensini scores were calculated for each group and the correlation between the Gensini score and the level of Hcy was explored.Results:1.The incidence of coronary heart disease in the group H1,group H2,and group H3 was 60%,5 6%,and 64%,respectively.The incidence of coronary heart disease was higher in each group than in the non-H-type hypertension group which was 32%;and there was a statistically significant difference among groups(P<0.05).2.The incidence of ACS in group H1,group H2,and group H3 was 60.00%,71.43%,and 78.12%,respectively;and the incidence of ACS in each group was higher than that of non-H hypertension group which was 31.25%;and there was a statistically significant difference among groups(P<0.05).3.In patients with H-type hypertension and coronary heart disease,the number of coronary artery involvement in H1,H2,and H3 groups were mainly double-vessel disease and multi-vessel disease,and the difference was statistically significant(P<0.05).4.The Gensini score is correlated with different level of Hcy in pations with H-type-hypertensive coronary heart disease.The linear correlation is Y(Gensini score)=-23.067 +3.738X(Hcy,mmol/1),and X≥10umol/L is meaningful(correlation coefficient r=0.905,P=0.000<0.01).Conclusions:1.In H-type hypertensive patients,the higher the Hcy concentration,the higher the prevalence of ACS,suggesting that Hcy levels correlate with the stability of coronary artery disease.2.In H-type hypertensive patients,with the increase of Hcy concentration,the higher the Gensini score,the more severe the coronary lesions,suggesting that H-type hypertension is positively correlated with the severity of coronary lesions.