The Study On The Characteristics Of Cardiovascular Structure And Function As Well As Their Relationships With Cognitive Function Among Perimenopausal Women With Hypertension

Objective: The characteristics of cardiovascular structure and function,cognitive function were compared between perimenopausal women with hypertension and non-hypertension,to explore the characteristics of cardiac structure and function,vascular function and cognitive function relationship among perimenopausal women with hypertension.Methods: Female patients with hypertension who underwent physical examination in the health management center of Lanzhou university second hospital from October 2016 to October 2017 were selected as the case group(n=355)aged45-60 years old.Selected 355 perimenopausal women with non-hypertenison as control group was matched by age,body mass index(BMI)and education in the same group of people.All subjects were surveyed by questionnaire,physical examinations included height,weight,BMI,waist-hip ratio.Blood test index included renal function,blood routine and blood serum lipid including total cholesterol(TC),triglyceride(TG)and LDL cholesterol(LDL-C).Blood pressure and heart rate were measured by OMRONH BP-9020.Echocardiography was used to measure cardiac structure and function.The indicators of heart structure included left atrial diameter(LAd),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),right ventricular diameter(RVd)and left ventricular posterior wall thickness(LVPWT),and cardiac function was checked by indicators of left ventricular ejection fraction(LVEF),cardiac motion amplitude,interval e',lateral e'and E/e',left atrial volume index(LAVI)and systolic pulmonary artery pressure(SPAP).vascular function was evaluated by indicators of cardio-ankle vascular index(CAVI)and ankle-arm index(ABI).The cognitive function of all subjects were evaluated by Mini-mental State Examination(MMSE).All data were statisticallyanalyzed by SPSS20.0.Results:(1)Through single factor conditional Logistic regression analysis,we found high salt intake,stress and family history of hyepertension were the risk factors of hypertension among perimenopausal women,while the family history of hypertension was the major risk factor after multiple factor conditional Logistic regression analysis;(2)For cardiac structure indicators:LAd?LVEDd?LVESd? IVS and LVPWT in perimenopausal women with hypertension were higher than those in perimenopausal without hypertension(P<0.05);(3)For cardiac function indicators,there were significant differences in left atrial volume index(LAVI),interval e' and lateral e' between perimenopausal female with hypertension and those without hypertension(P<0.05);(4)For vascular function indicators,right cardio-ankle vascular index(CAVI-R),left cardio-ankle vascular index(CAVI-L)and right ankle-arm index(ABI-R)were significantly higher in perimenopausal women with hypertension than those in perimenopausal without hypertension(P<0.05);(5)Among perimenopausal women,the influence factors of cardiac structure were age,blood pressure,BMI and waist-hip ratio,the influence factors of cardiac function were blood pressure,heart rate,age and waist-hip ratio,and the vascular function was mainly affected by age,blood pressure,serum lipid and menopause;(6)Among perimenopausal women with hypertension,the influence factor of cardiac structure was BMI,the influence factors of cardiac function were age,education,waist-hip ratio and menopause,and the vascular function was mainly affected by age and menopause;(7)More people with mild cognitive impairment were found in hypertension group than the control group,but with no significance differences,which was similar in the comparison of MMSE score;(8)Mutiple linear regression analysis showed that the main influencing factors of cognitive function were age,lower vascular function and menopause;(9)The main influencing factors of cognitive function among perimenopausal women with hypertension were age,menopause and dysfunction of the vascular.Conclusions:(1)The high-salt diet,stress and early family history of hypertension were the risk factors of hypertension among perimenopausal women.Perimenopausal women with early family history of hypertension own substantial changes of cardiovascular structure and function,so the early family history of hypertension may be the major risk factor hypertension among perimenopausal women.(2)Among perimenopausal women with hypertension,the cardiac structureand function may be affected by blood pressure,age,education,BMI and menopause,and the vascular function may be affected by blood pressure,age and menopause;(3)Perimenopausal women with hypertension own normal but declining cognitive function,which may be affected by age and hypertension.