| Aim:To investigate the relationship between heart rate variability(HRV)and carotid intima-media thickness(IMT)in patients with coronary heart disease complicated with hypertension and its clinical significance.Methods:128 patients with coronary heart disease complicated with hypertension were selected as a coronary heart disease with hypertension group inour department of cardiology in the hospital from May 2017 to October 2018.At the same period,92 patients with hypertension were selected as a hypertension group.All patients were taken the Carotid ultrasound to measure IMT.According to the results of IMT,each group is further divided into normal carotid intima group(IMT1): IMT<0.10 cm,and no plagues in arterial lumen,among them,24 patients with coronary heart disease complicated with hypertension and 18 patients with hypertension alone;carotid intima-media thickening group(IMT2):0.10cm?IMT?0.13 cm,and no plagues in arterial lumen,among them,57 patients with coronary heart disease complicated with hypertension and 28 patients with hypertension alone;carotid intima-hardening plaque group(IMT3):IMT>0.13 cm,with or without luminal calcification or stenosis,among them,47 patients with coronary heart disease complicated with hypertension and 46 patients with hypertension alone.220 patients were taken the echocardiography,synchronous 24-hour dynamicelectrocardiogram(DCG)to measure the HRV time domain analysis indicators(SDNN,SDNNindex,SDANN,RMSSD,PNN50),and compare between the two groups and each group.Results:1.Compared with the hypertension group,TC,TG,LDL-C,sdLDL-C and FPG were significantly increased in the patients with coronary heart disease and hypertension,and the difference was statistically significant(P<0.05).HDL-C significantly decreased,and with IMT thickening,TC,TG,LDL-C,sdLDL-C,FPG all showed an increasing trend,HDL-C showed a downward trend;2.Compared with simple hypertension group,coronary heart disease combined in the hypertension group,SDNN,SDNNindex,SDANN,RMSSD,and PNN50 were significantly lower(P<0.05).3.In the simple hypertension group,with IMT thickening,there was no significant difference in the levels of SDNN,SDNNindex,and SDANN,and PNN50 was significantly decreased.In the coronary heart disease with hypertension group,with the increase of IMT thickness,there was no significant difference between SDNN,SDNNindex and SDANN,PNN50 and RMSSD decreased significantly.4.Correlation analysis showed that TC,TG,LDL-C,sdLDL-C,FPG Positive correlation with IMT,HDL-C,SDANN,RMSSD,PNN50 and IMT were negatively correlated;5.Logistic regression showed that RMSSD,PNN50,SDANN are the influencing factors of coronary heart disease in patients with hypertension,and their OR values were 0.931,respectively 0.83,0.978;in patients with simple hypertension,RMSSD and PNN50 were associated with IMT thickening,with OR values of 0.973 and 0.928,respectively;in patients with coronary heart disease and hypertension,RMSSD,PNN50,and SDANN are closely related to IMT,and their OR values are 0.912,0.691,and 0.974,respectively.Conclusion:1.Coronary artery intima-media thickness in patients with coronary heart disease and hypertension with aggravation of total cholesterol,triglyceride,low-density lipoprotein,small dense low-density lipoprotein,fasting blood glucose,with high density The increase of lipoprotein has a tendency to decrease.The disorder of glucose and lipid metabolism is an important risk factor for carotid atherosclerosis in patients withcoronary heart disease and hypertension.2.The time-domain index of heart rate variability in patients with coronary heart disease and hypertension is reduced,suggesting that patients have sympathetic nerves.Parasympathetic function coordination ability decreased;3.Simple hypertension and coronary heart disease with hypertension,vagus nerve function reduction and carotid atherosclerosis process are closely related;4.Vagus nerve dysfunction is high blood pressure patients susceptible to coronary heart disease Independent risk factors. |
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