Correlation Analysis Of S-AASI And Coronary Atherosclerosis In Patients With Primary Hypertension

Objective:To investigate the relationship between symmetric dynamic arteriosclerosis index and coronary heart disease in 438 patients with essential hypertension in our hospital,and to study the related influencing factors of symmetric dynamic arteriosclerosis index.Methods:A retrospective study was conducted to analyze 438 patients with essential hypertension and chest pain who were hospitalized in our hospital from January 2015 to September 2017..Coronary angiography(CAG)and ambulatory blood pressure(ABPM)were performed at the same time.The age was 58.88±10.02 years old,including 266 males and 172 females.According to the results of coronary angiography,the patients were divided into two groups:coronary heart disease group and non-coronary heart disease group.The coronary heart disease group was divided into three groups according to the number of coronary artery lesions:single-vessel disease group,double-vessel disease group and three-vessel disease group,according to Gensini scoring system.Coronary lesion scores were calculated in patients with coronary heart disease.Record general information(including age,height,weight,sex,urban and rural history,smoking history,history of hypertension,etc.)and laboratory-related test results(including fasting blood glucose(FBG),total cholesterol(TC),glycerol)Triglyceride(TG),low density lipoprotein cholesterol(L-DLC),high density lipoprotein cholesterol(H-DLC),thyroid stimulating hormone(TSH),etc.,ambulatory blood pressure monitoring results(white,night,24 hour average Systolic and diastolic blood pressure mean and coefficient of variation,24-hour average heart rate)and BMI(BMI=weight/height2),24h dynamic pulse pressure(24hPP),symmetric dynamic arteriosclerosis index(S-AASI).S-AASI = 1-[r/β(S/D)]Statistical analysis of the above clinical data was performed.The measurement data that met the distribution of Zhengtai were expressed as mean±standard deviation(X±SD).The t-test was used for comparison between the two groups.The quantile was used for the measurement data that did not meet the distribution of positive and too.The Mann-Whitney U test was used to compare the two groups;the count data were expressed as a percentage(%),and the chi-square test was compared between the groups.The three-group analysis was used to analyze the S-AASI between different coronary lesions.Value;further two-two comparison using LSD method;multivariate logistic regression analysis of risk factors affecting coronary heart disease;ROC curve was used to predict the diagnostic value of S-AASI in patients with essential hypertension with coronary heart disease;The relationship between AASI and Gensini scores;finally,multiple linear regression analysis was used to explore the factors affecting S-AASI.All of the above were analyzed by SPSS21.0 software,and the difference was statistically significant at P<0.05.Results:1.A total of 438 patients with primary hypertension,258 patients with coronary heart disease,and 180 patients with non-coronary heart disease were included in the study.The smoking history,S-AASI and dSBP mean of the two groups were statistically significant(P<0.05).There were no significant differences in age,gender,urban and rural,BMI,FBG,TC,TG,L-DLC,H-DLC,hypertension course,and blood pressure index(P>0.05).2.Logistic regression analysis was performed on whether coronary heart disease occurred as a dependent variable in patients with essential hypertension.The results showed that age(OR 1.003,95%CI 1.010～1.057),smoking(OR 2.514,95%CI 1.517～4.166),S-AASI(OR 1.986,95%CI 1.538～2.564)was independently associated with the development of coronary heart disease.3.With or without coronary heart disease as the state variable,the ROC curve was constructed with S-AASI as the test variable.The results showed that the AUC of S-AASI in the diagnosis of coronary heart disease in patients with essential hypertension was 0.654((0.602～0.707)).The sensitivity was 78.7%and the specificity was 45.4%(P<0.01).4.Of Among 258 patients with coronary heart disease,113 patients had single-vessel disease group,80 patients had double-vessel disease group,and 65 patients had three-vessel disease group.The S-AASI value increased gradually with the increase of coronary artery lesions in the three groups.There were significant differences between the groups(P<0.05).Pearson correlation analysis between S-AASI and Gensini score showed that S-AASI was positively correlated with Gensini score(r=0.449,P<0.05).5.In this study,S-AASI was associated with age,smoking,mean systolic blood pressure,mean nighttime systolic blood pressure,24-hour mean systolic blood pressure,daytime mean diastolic blood pressure,nocturnal mean diastolic blood pressure,24-hour mean diastolic blood pressure,and 24-hour mean pulse pressure.There was a significant positive correlation(r>0,P<0.05);there was no significant correlation with 24-hour average heart rate,BMI,blood glucose,triglyceride,cholesterol,and hypertension(P>0.05).Conclusion:1.S-AASI has a medium predictive value for the diagnosis of coronary heart disease in patients with essential hypertension.It is a simple,safe and reliable non-invasive method of examination for heart disease for patients with essential hypertension.2.S-AASI may be associated with the severity of coronary artery disease in patients with hypertension and coronary heart disease.3.S-AASI was positively correlated with age,smoking,mean systolic blood pressure,mean nighttime systolic blood pressure,24-hour mean systolic blood pressure,daytime mean diastolic blood pressure,nocturnal mean diastolic blood pressure,24-hour mean diastolic blood pressure,and 24-hour pulse pressure.