Relationship Between Cardio-ankle Vascular Index,Ankle-brachial Index And Community Hypertension,Coronary Heart Disease And Its Influential Factors

Objective:The cardio-ankle vascular index(CAVI)and ankle-brachial index(ABI)are good indicators for evaluating the degree of arteriosclerosis and obstruction of arteries.We surveyed people who had health check-up examination from a community health service center in Guangzhou City;To investigate and analysis the relationship between the CAVI and ABI in community population with hypertension and coronary heart disease and its related factors;To provide theoretical basis and practical information for prevention and treatment of arteriosclerosis-related diseases such as hypertension and coronary heart disease in community population.Method:Through the“Community Cardiovascular and Cerebral Disease Spectrum Questionnaire”,the records of the general information and behavioral habits of the subjects were collected,and blood biochemical indicators were examined.In addition,CAVI and ABI were detected.A total of 706 cases of physical examination were collected,and there are590 cases of standards-compliant.There were 162 cases(27.46%)of normal physical examination;198 cases(33.56%)of simple hypertension,among them 116 patients(58.59%)with primary hypertension,47 patients(23.74%)with grade two hypertension and 35 cases(17.67%)of grade three hypertension;88 cases(14.92%)of simple coronary heart disease,among them 57 patients(64.77%)with stable angina pectoris and 31patients(35.23%)with unstable angina pectoris;142 cases(24.06%)of concurrence.According to the CAVI value and ABI value,investigation objects were divided into CAVI normal group(CAVI<9m/s)and elevated group(CAVI?9m/s),ABI normal group(ABI>0.9)and abnormal group(ABI?0.9).Application SPSS17.0 statistical analysis of the above information,between normal physical examination and measurement data for each patient group and CAVI,ABI differences between different levels of hypertension groups were compared using analysis of variance(F test);The comparison of CAVI and ABI between groups of different types of coronary heart disease and the comparison of data between different groups of CAVI and ABI using t test;The count data of each group were compared by the?~2 test;Correlation analysis of CAVI,ABI and hypertension and coronary heart disease using Spearman grade correlation coefficient;Risk factors were analyzed using binary Logistic regression forward stepwise selection method;P<0.05 was considered statistically significant differences.Results:1.The difference of general information and blood biochemical indexes and CAVI,ABI in normal physical examination group and each disease groupComparison of the normal physical examination group,simple hypertension group,simple coronary heart disease group and the concurrent group;age,BMI,WC,HC,white blood cells,TG,HDL-C,FBG,creatinine,CAVI,ABI were statistically significant differences among the four groups(P<0.05).Compare with each other found that there were significant differences in BMI,HC,TG,HDL-C and ABI between simple hypertension group and simple coronary heart disease group(P<0.05);The difference of BMI,WC,HDL-C and ABI between simple coronary heart disease group and concurrent group was statistically significant(P<0.05);There were significant differences in age,WC,creatinine,CAVI,ABI between the concurrent group and the normal group(P<0.05);The difference of age,BMI,HC,leucocyte,FBG,creatinine and CAVI between normal physical examination group and simple hypertension group was statistically different(P<0.05);There were significant differences in age,leucocyte,TG,FBG,creatinine,CAVI,ABI between the normal control group and the simple coronary heart disease group(P<0.05);The differences of age,WC,HC,TG and ABI between the concurrent group and the simple hypertension group were statistically different(P<0.05).2.Correlation of hypertension and coronary heart disease with CAVI and ABIThe difference in CAVI between different levels of hypertension was statistically significant(P<0.05);Compare with each other found that there was a significant difference between the three grade hypertension group and the first grade hypertension group,the two level hypertension group and the first grade hypertension group(P<0.05);Spearman correlation analysis showed that there was a significant positive correlation between CAVI and the level of hypertension(r=0.362,P<0.001);Binary Logistic regression analysis showed that increased CAVI(?=1.035,OR=2.814,95%CI=2.141~3.700)and increased BMI(?=0.079,OR=1.082,95%CI=1.007~1.164)were independent risk factors for the incidence of hypertension.The differences in CAVI and ABI between different types of coronary heart disease were statistically significant(P<0.05);Spearman correlation analysis showed that there was a significant positive correlation between CAVI and type of coronary heart disease(r=0.638,P<0.001),and ABI was negatively correlated with type of coronary heart disease(r=-0.831,P<0.001).Binary Logistic regression analysis showed that ABI(?=-5.147,OR=0.006,95%CI=0.000~0.701)and TG(?=-0.541,OR=0.582,95%CI=0.350~0.968)were the protective factors of coronary heart disease,while CAVI increased(?=0.863,OR=2.371,95%CI=1.656~3.394),ABI and TG abnormalities were independent risk factors for the incidence of coronary heart disease.3.Related risk factors of CAVI and ABI in community health check-up populationBinary Logistic regression analysis showed that there was a significant negative correlation between physical exercise and CAVI(?=-0.642,OR=0.526,95%CI=0.343-0.808),which was the protective factor of CAVI;Lack of physical exercise,smoking(?=0.722,OR=2.059,95%CI=1.407~3.014),age increase(?=0.069,OR=1.071,95%CI=1.049~1.094),elevated SBP and FBG(?=0.033,OR=1.033,95%CI=1.022~1.045;?=0.196,OR=1.217,95%CI=1.067~1.387),white blood cell abnormalities(?=0.117,OR=1.124,95%CI=1.003~1.259)are the independent risk factor for CAVI increased.Binary Logistic regression analysis showed that there was a significant negative correlation between DBP,red blood cells and ABI(?=-0.025,OR=0.975,95%CI=0.956~0.994;?=-0.331,OR=0.718,95%CI=0.517~0.997),which were the protective factor of CAVI;Gender(?=0.561,OR=1.753,95%CI=1.206~2.550),smoking(?=0.828,OR=2.289,95%CI=1.574~3.328),increased age(?=0.047,OR=1.048,95%CI=1.028~1.068),increased WC(?=0.030,OR=1.030,95%CI=1.009~1.051),red blood cell abnormalities and elevated DBP were independent risk factors for ABI abnormalities.Conclusion:1.The larger the CAVI value,the higher the level of hypertension.Increased age,elevated SBP and FBG,abnormal white blood cells,smoking,lack of physical activity could increase the risk of atherosclerosis in hypertensive people in the community,further accelerating the vascular stiffness and elasticity of the lesions.2.The larger CAVI value and the lower ABI value,the higher the incidence of unstable angina in the population.Gender(female),smoking,lack of physical exercise,age increase,WC increase,blood pressure and FBG,white blood cell and red blood cell abnormalities can increase the risk of atherosclerosis in community patients with coronary heart disease,and further promote the severity of coronary artery disease.3.Smoking and age increased are common risk factors for CAVI elevation and ABI abnormalities.With age increasing,smoking population are more likely to have arterial sclerosis and vascular stenosis and obstruction,thereby increasing the risk of hypertension and coronary heart disease.