Correlation Between Plasma Homocysteine Levels And Blood Pressure Variation In Patients With Coronary Heart Disease

Objective:This study aimed to explore the correlation between plasma homocysteine level and blood pressure variability in patients with coronary heart disease,and to provide more clinical theoretical basis for the prevention and treatment of risk factors in coronary heart disease.Methods:1.Part one:A total of 116 hospitalized coronary heart disease patients from January 2019 to July 2019 in kunming first people's hospital of the department of cardiology.All of the selected patients were diagnosed coronary heart disease according to the results of coronary angiography.And above patients were divided into observation group and control group based on the level of homocysteine.The observation group(n=64)is coronary heart disease combined with hyperhomocystinemia(Hcy?10mmol/L),and the control group(n=52)is coronary heart disease combined with low level homocysteine(Hcy<10mmol/L).The observation group and control group group were not statistically significant in Gender,age,history of hypertension and diabetes(P>0.05).Comparing the general data,serum biochemical indexes and blood pressure variability indexes between the two groups.Then to explore the relationship between serum homocysteine and blood pressure variability in patients with coronary heart disease.2.Part two:The 116 patients above were divided into coronary heart disease combined with hypertension group(n=63)and coronary heart disease without hypertension group(n=53).Analysis the general conditions,serum biochemical indexes and blood pressure variability indexes between the two groups.And explore the relationship between serum homocysteine and blood pressure variability in these two groups.Results:1.Comparison of the clinical data,serum biochemical indexes and blood pressure variability indexes between the observation group and the control group showed that uric acid,fasting blood glucose,direct bilirubin,blood glucose,homocysteine,24 hours systolic blood pressure standard deviation and 24 hours diastolic blood pressure standard deviation,24 hours systolic blood pressure variation coefficient and 24 hours diastolic blood pressure variation coefficient in observation group higher than control group,the differences was significant(P<0.05).2.Pearson correlation analysis of all the patients found that 24 hours systolic blood pressure standard deviation was positively correlated with uric acid(r=0.347,P<0.001),homocysteine(r=0.505,P<0.001),cholesterol(r=0.324,P<0.001).24 hours diastolic pressure standard deviation was positively correlated with RBC(r=0.187,P=0.045),hemoglobin(r=0.241,P=0.009),homocysteine(r=0.51,P<0.001),uric acid(r=0.289,P=0.002),cholesterol(r=0.196,P=0.035).24 hours systolic blood pressure variation coefficient was positively correlated with uric acid(r=0.409,P<0.001),homocysteine(r=0.516,P<0.001),and cholesterol(r=0.343,P<0.001).24 hours diastolic blood pressure variation coefficient was positively correlated with uric acid(r=0.347,P<0.001),direct bilirubin(r=0.214,P=0.021),homocysteine(r=0.556,P<0.001)and cholesterol(r=0.324,P<0.001).In multivariate linear regression analysis,the correlation between Hcy and 24h SSD was significant(?=0.127,P<0.001),the correlation between Hcy and 24h DSD was significant(?=0.108,P<0.001),the correlation between Hey and 24h SCV was significant(?=0.001,P=0.001),the correlation between Hcy and 24h DCV was significant(?=0.002,P<0.001).3.The comparison of general clinical data,serum biochemical indexes and blood pressure variation indexes between the coronary heart disease combined with hypertension group and the coronary heart disease without hypertension group showed that the PT,fasting blood glucose,urea nitrogen,Hcy and 24h DSD in the coronary heart disease without hypertension group higher than the coronary heart disease combined with hypertension group,the differences was significant(P<0.05).4.Pearson correlation analysis of the general clinical data,serum biochemical indexes and blood pressure variation indexes in coronary heart disease combine with hypertension group found that 24 hours systolic blood pressure standard deviation was positively correlated with uric acid(r=0.314,P=0.012),homocysteine(r=0.483,P<0.001),and cholesterol(r=0.305,P=0.015).24 hours diastolic pressure standard deviation was positively correlated with RBC(r=0.252,P=0.046),hemoglobin(r=0.268,P=0.034),indirect bilirubin(r=0.228,P=0.022),homocysteine(r=0.425,P<0.001).24 hours systolic blood pressure variation coefficient was positively correlated with uric acid(r=0.407,P=0.001),homocysteine(r=0.511,P<0.001)and cholesterol(r=0.42,P=0.001).24 hours diastolic blood pressure variation coefficient was positively correlated with uric acid(r=0.269,P=0.033),homocysteine(r=0.484,P<0.001).In multivariate linear regression analysis,the correlation between Hcy and 24h SSD was significant(?=0.158,P=0.006),the correlation between Hcy and 24h DSD was significant(?=0.123,P<0.001),the correlation between Hcy and 24h SCV was significant(?=0.001,P=0.011),the correlation between Hcy and 24h DCV was significant(?=0.002,P<0.001).5.Pearson correlation analysis of the general clinical data,serum biochemical indexes and blood pressure variation indexes in coronary heart disease without hypertension group found that 24 hours systolic blood pressure standard deviation was positively correlated with uric acid(r=0.375,P=0.006),homocysteine(r=0.512,P<0.001)and cholesterol(r=0.319,P=0.02).24 hours diastolic pressure standard deviation was positively correlated with homocysteine(r=0.549,P<0.001),uric acid(r=0.334,P=0.015)and cholesterol(r=0.274,P=0.047).24 hours systolic blood pressure variation coefficient was positively correlated with uric acid(r=0.417,P=0.002),homocysteine(r=0.517,P<0.001).24 hours diastolic blood pressure variation coefficient was positively correlated with uric acid(r=0.424,P=0.002),direct bilirubin(r=0.334,P=0.015),homocysteine(r=0.624,P<0.001).In multivariate linear regression analysis,the correlation between Hcy and 24h SSD was disappeared(?=0.094,P=0.069),the correlation between Hcy and 24h DSD was significant(?=0.088,P=0.026),the correlation between Hcy and 24h SCV was disappeared(?<0.001,P=0.635),the correlation between Hcy and 24h DCV was significant(?=0.001,P=0.004).Conclusion(s):1.In the patients with coronary heart disease,Hcy is positively correlated with 24h SSD,Hcy is positively correlated with 24h DSD,Hcy is positively correlated with 24h SCV,and Hcy is positively correlated with 24h DCV.In other words,Hcy is related to BPV in patients with coronary heart disease,Hcy and BPV may be have a synergistic effect on the occurrence and development of coronary atherosclerosis in patients with coronary heart disease.2.Hcy and BPV are positively related in patients with coronary heart disease combine with hypertension.In the management of these patients,we should not only pay a attention to the management of blood pressure level,but also keep an eye on Hcy and BPV to prevention and treatment of coronary heart disease.3.The correlation between Hcy and 24h SSD,24h SCV were disappeared In multivariate linear regression analysis,and Hcy was correlated with 24h DSD,24h DCV.Therefore,Hcy may be more closely related to diastolic blood pressure in patients with coronary heart disease without hypertension.