| Aim:Explore the relationship between H-type hypertension and carotid plaque stability.Materials and Methods:1.From January 2018 to January 2019,128 patients with H-type hypertension diagnosed in the Department of Cardiology of Yan'an University Affiliated Hospital were randomly selected.130 patients with primary hypertension were diagnosed.All patients collected general information.(age,gender,height,weight,history of diabetes,history of smoking,history of drinking,history of medication,etc.).2.Laboratory examination: All patients underwent fasting blood glucose,TC,TG,HDL-C,LDL-C,hs-CRP,CRP,CRE,and plasma HCY in the second sky.24 h ambulatory blood pressure was performed.3.Carotid ultrasound: record the condition of the blood vessels in the neck and the presence or absence of carotid plaque,the location,number,size,shape and ultrasound properties of the plaque.The IMT values of carotid blood vessels were measured and the stability of carotid plaques was compared between the two groups.4.Echocardiography: Measurement of left ventricular morphological structure,left ventricular function and EF value.Results:1.H-type hypertension group: plasma HCY level: 28.63±3.94umol/L;plasma HCY level in patients with essential hypertension: 7.58±1.66 umol/L.2.Carotid ultrasound examination results: 100 patients with carotid plaque detected in H-type hypertension group,a total of 189 plaques,the detection rate of plaque was 78.13%.Among the patients with essential hypertension,39 of them had plaques and 86 had plaques.The plaque detection rate was 30%,and the difference in plaque detection rate between the two groups was statistically significant(p<0.05).Carotid IMT value and plaque stability: 85 cases of unstable(low echo,iso-echo,mixed echo)plaque in H-type hypertension group,the detection rate was 66.41%,15 cases of stable plaque were detected,and detected.The rate was 11.72%,there were 28 cases without plaque,and the detection rate was 21.88%.In the primary hypertension group,20 cases of unstable plaque(low echo,equal echo,mixed echo),the detection rate was 15.38%,19 cases of stable plaque,the detection rate was 14.62%,91 cases without plaque,The detection rate was 70%.The composition of unstable plaques in the two groups was statistically significant.The IMT of the carotid artery in the H-type hypertension group was 1.15±0.15 mm,and the IMT value of the carotid artery in the primary hypertension group was 0.8±0.12 mm.The difference in carotid intima thickness between the two groups was statistically significant(P< 0.05).The overall location distribution of the plaques in the two groups: according to the common parts of the common carotid artery,internal carotid artery,external carotid artery,subclavian artery,and internal and external carotid artery bifurcation.The overall distribution of arterial plaque position between the two groups was not statistically significant.Significance(P>0.05).3.A scatter plot of carotid plaque stability and plasma HCY levels was plotted in 258 hypertensive patients.From the scatter plot analysis,there was a correlation between carotid plaque echo characteristics and plasma HCY levels in the two groups.4.Logistic multivariate regression analysis: patient age,IMT and plasma HCY were risk factors for carotid plaque instability.Conclusions:1.The incidence of carotid unstable plaques in H-type hypertension group was higher than that in essential hypertension group,and plasma HCY level and hypertension may have synergistic effect in the process of carotid plaque.2.Plasma HCY elevation was positively correlated with carotid plaque instability,and H-type hypertension was an independent risk factor for carotid plaque stability. |
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