Analysis Of Cardiovascular Damage And Risk Factors In Perimenopausal Hypertensive Patients

Objective:To analyze the difference of cardiovascular structure and function between perimenopausal hypertension group and normal blood pressure group,in order to explore the risk factors of cardiovascular structure and function in perimenopausal hypertension patients.Methods:According to the inclusion and exclusion criteria,200 patients with perimenopausal hypertension who visited the physical examination center,outpatient and inpatient departments of the First Hospital of Shanxi Medical University and the Bethune Hospital in Shanxi Province from September 2021 to September 2022,were selected as the hypertension group,and 200 women with normal blood pressure during perimenopause who presented during the same period were selected as the normal blood pressure group,aged 45-60 years.Collect the general data and serological indicators of the subjects,including four items of blood lipids,Fasting blood glucose(FBG),Homocysteine(HCY),uric acid(UA)and cystatin C(Cys C),and cardiac structural indexes include left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic diameter(LVEDd),left ventricular posterior wall thickness(LVPWT),left atrial anteroposterior diameter(LAd),left atrial maximum volume index(LAVI),right ventricular anteroposterior diameter(RVd)and ventricular septal thickness(IVS).Cardiac function indexes include the ratio of peak blood flow velocity(E)in early mitral valve diastolic(E)to peak blood flow in late diastolic(A),pulmonary artery systolic blood pressure(PASP),left ventricular ejection fraction(LVEF),lateral wall e’,septal e’,ratio(E/e’)of early mitral diastolic blood flow velocity(E)and mitral valve diastolic peak movement velocity(e’),and stroke amplitude;The indexes of vascular endothelial function include brachial-ankle pulse wave conduction velocity(ba PWV)and ankle-brachial blood pressure index(ABI).SPSS25.0 statistical software was used to statistically analyze the influencing factors of cardiovascular structure and function in perimenopausal hypertensive patients.Results:1.Multivariate logistic regression found that family history of waist-hip ratio,HCY,UA,Cys C and hypertension were associated with an increased risk of perimenopausal hypertension,and the differences were statistically significant(P<0.05).2.Cardiac structure and functional indexes: LAd,LVESd,LVEDd,IVS,LVPWT and E/e’ were significantly higher in the hypertension group than in the normal blood pressure group,while the interval e’,sidewall e’ and E/A were significantly lower than those in the normal blood pressure group,and the difference was statistically significant(P<0.05),and there was no significant difference in the indexes of LAVI,RVd,stroke amplitude,PASP and LVEF between the two groups(P>0.05).3.The bilateral ba PWV of the hypertension group was significantly higher than that of the normotensive group(P<0.05),while the difference between the two groups was not statistically significant(P>0.05).4.The influencing factors of cardiac structure in perimenopausal women include BMI,waist to hip ratio,blood pressure and menopause;The influencing factors of cardiac function index include age,BMI,waist to hip ratio,blood pressure,and heart rate;The influencing factors of vascular endothelial function include age,blood pressure,menopause and Cys C.5.The influencing factors of cardiac structure in perimenopausal women with hypertension include BMI,waist to hip ratio,alcohol and menopause;The influencing factors of cardiac function index include age,BMI,waist to hip ratio,menopause,education level;The influencing factors of vascular endothelial function include age,menopause,alcohol and family history.Conclusion:1.The influencing factors of perimenopausal hypertension mainly include waist-hip ratio,HCY,UA,Cys C and family history.2.The influencing factors of cardiac structure and function in patients with perimenopausal hypertension mainly include blood pressure,heart rate,BMI,waist to hip ratio,menopause,education level and alcohol;The factors influencing vascular endothelial function mainly include age,family history,menopause and alcohol.3.Cardiovascular damage in patients with perimenopausal hypertension is mainly manifested in left atrial enlargement,LVH,hypodiastolic function,HFp EF and increased arterial stiffness,and risk factors should be intervened as soon as possible,which is very beneficial to prevent cardiovascular damage caused by hypertension.