Effects Of Lipid-Regulating Therapy On Arteriosclerosis In Elderly Patients With Different Types Of Obesity And Hypertension

Objective:1.To observe the effects of lipid-regulating therapy and different types of obesity on improving the degree of arteriosclerosis in elderly patients with hypertension.2.To investigate the interaction between lipid-regulating therapy and different types of obesity in improving the degree of arteriosclerosis in elderly patients with hypertension.3.To analyze the effect of lipid-regulating therapy on endpoint events in elderly patients with different types of obesity and hypertension.Methods:From September 2016 to September 2017,we conducted health check-up activities for the elderly in different communities in Jinan City,the elderly patients with primary hypertension who met the requirements of the study were screened out.After two week of introduction,408 patients were included in the study,who were excluded from intolerance and poor compliance to the test drug.There were 225 males and 183 females aged(72.64 ±5.70)years.The subjects were divided into 4 groups: Fat regulation abdominal obesity group(RAO,n=103),fat regulating non-abdominal obesity group(RNO,n=81)and abdominal obesity control group(AOC,n=127),non-abdominal obesity control group(NOC,n=97).All patients were treated with candesartan(8 mg/d)for 2 weeks,and lipid-lowering group(10 mg/d).If the antihypertensive effect was not satisfactory,the dose of candesartan was increased to 12mg/d.The patients were followed up quarterly,including physical examination,blood pressure measurement,blood test,measurement and calculation of atherosclerotic indicators,medication records,end-point events and adverse events records.Results:1.After treatment,compared with the other groups,SBP,TG,LDL-C and AI in the RAO group decreased,while HDL-C and ABI increased(P<0.05).Compared with the two control groups,SBP?DBP?TG?TC?LDL-C and AI in the RNO group were decreased,while HDL-C and ABI increased(P<0.05).Compared with the NOC group,TG?TC?LDL-C and AI in the AOC group decreased,while HDL-C and ABI increased(P<0.05).2.After taking gender and BMI as control variables,SBP was positively correlated with DBP,PP,TG,TC and AI(r=0.536,0.295,0.171,0.129,0.183,P<0.05)and negatively correlated with ABI(r=0.415,P<0.05).TG was positively correlated with SBP,TC,LDL-C,and AI(r=0.171,0.614,0.266,0.685,P<0.05),and negatively correlated with HDL-C(r=0.104,P<0.05).TC was positively correlated with SBP,TG,LDL-C,and AI(r=0.129,0.614,0.465,0.755,P<0.05),and negatively correlated with HDL-C(r=0.135,P<0.05).LDL-C was positively correlated with TG,TC,and AI(r=0.266,0.465,0.361,P<0.05).HDL-C was negatively correlated with TG,TC,and AI(r=0.104,0.135,0.188,P<0.05).ABI was positively correlated with SBP,DBP and PP(r=0.415,0.109,0.168,P<0.05).AI was positively correlated with SBP,TG and TC(r=0.183,0.685,0.755,P<0.05).3.ABI was positively correlated with age,SBP,PP and TC(r=0.172,0.559,0.169,0.151,P<0.05),and negatively correlated with waist circumference and BMI(r=-0.207,-0.138,P<0.05).The results showed that the regression equation was: ABI=0.911+0.012×age-0.006×waist circumference+0.002×SBP-0.068×TC.AI was positively corr elated with age,waist circumference,BMI,SBP,TG,TC,and LDL-C(r=0.197,0.252,0.304,0.126,0.115,0.856,0.108,P<0.05),and negatively correlated with HDL-C(r=-0.937,P<0.05).The results showed that the regression equation was: AI=0.523+0.008×age +0.005×waist circumference +0.028×BMI+0.160×TC-0.252×HDL-C.4.After treatment,SBP,TG,LDL-C,AI and HDL-C were decreased,and ABI and ABI were increased in the two groups of subjects treated with lipid-regulating therapy compared with the two groups of subjects not treated with lipid-regulating therapy(P<0.05).5.After treatment,SBP,TG,LDL-C and AI of the two groups of subjects with abdominal obesity were decreased compared with the two groups of subjects with non-abdominal obesity,but still higher than that of the non-abdominal obesity group,and HDL-C and ABI were increased(P<0.05).6.After treatment,SBP,DBP,TG,TC,LDL-C,ABI and AI in different treatment groups showed a synergistic effect with time(P<0.05).Between the different treatment time point group SBP,DBP,TG,TC,LDL-C,HDL-C,ABI,AI,lipid abdominal obesity group and lipid of ABI in abdominal obesity group,AI have obvious change trend,ABI,AI in 3 months began to stabilize,other indicators since 3 months began to change(P < 0.05).The changes of SBP,DBP,TG,TC,LDL-C,ABI and AI in the RAO group were greater than those in the other three groups,but the levels of various indexes were still higher than those in the RNO group(P>0.05).7.In the RAO group,2 cases/time of death,4 cases/time of stroke,34 cases/time of myocardial infarction,5 cases/time of admission due to hypertension and hyperlipidemia,19 cases/time of hypotension,a total of 34 cases/time.In the RNO group,1 case/time of death,3 cases/time of stroke,3 cases/time of myocardial infarction,4 cases/time of admission due to hypertension and hyperlipidemia,12 cases/time of hypotension,a total of 23 cases/time.In the AOC group,3 cases/time of death,7 cases/time of stroke,9 cases/time of myocardial infarction,12 cases/time of admission due to hypertension and hyperlipidemia,6 cases/time of hypotension,a total of 37 cases/time.In the NOC group,1 case/time of death,4 cases/time of stroke,6 cases/time of myocardial infarction,8 cases/time of admission due to hypertension and hyperlipidemia,4 cases/time of hypotension,a total of 23 cases/time.8.After controlling for age,the risk of all endpoint events in the AOC group was defined as 1.The regression analysis results showed that the OR values of the other three groups were all less than 1.Among them,OR=0.453 and P value less than 0.05 in RNO group with lipid-regulating function were protective factors for endpoint events.The P value of the RAO group and the NOC group was greater than 0.05,which was not associated with the presence of endpoint events.Conclusion:1?Lipid-regulating therapy can reduce the blood pressure level of elderly patients with hypertension and abdominal obesity,effectively regulate blood lipid level,improve the degree of atherosclerosis,prevent and control the occurrence and development of atherosclerosis disease.2.The antihypertensive effect of senile hypertension patients with non-abdominal obesity is better than that of patients with abdominal obesity.Improving the degree of abdominal obesity can strengthen the effective control of blood pressure.3.In treatment,there are interactions between different treatments and different types of obesity.4.In treatment,lipid-lowering therapy can significantly reduce the incidence of related adverse events.