Correlation Analysis Between H-type Hypertension And Acute Recurrent Ischemic Stroke

Objective:To explore the correlation between H-type hypertension and acute recurrent cerebral infarction,and analyze the risk factors of recurrent cerebral infarction.Methods:A total of 236 patients with acute cerebral infarction admitted to the General Hospital of XXX from October 2020 to October 2022 were continuously collected and divided into acute first cerebral infarction group(initial group)and acute recurrent cerebral infarction group(recurrent group).A case-control study was conducted between the two groups(acute first cerebral infarction group as control group and acute recurrent cerebral infarction group as observation group).The general clinical data(gender,age,blood pressure,history of smoking and drinking,previous history of hypertension,diabetes,etc.)of the hospitalized patients were collected.We recorded the laboratory examination(plasma homocysteine level,blood lipid,blood routine,liver function,renal function,coagulation function,thromboelastogram,etc.)and imaging data(cerebrovascular ultrasound,etc.).According to whether the patients had hypertension and the level of plasma homocysteine,the patients with acute cerebral infarction were divided into H type hypertension group and non-H type hypertension group.SPSS26.0 software and R language were used for single factor analysis,multiple factor analysis and interaction analysis.Results:1.Univariate analysis of general data,examination results and laboratory indexes of patients with cerebral infarction in the initial group and recurrent group showed that:There were significant differences in age,history of hypertension,systolic blood pressure,history of diabetes,homocysteine level,incidence of H-type hypertension,carotid plaque and intimamedia thickness between the two groups(P<0.05).Multivariate logistic regression analysis showed that:H-type hypertension(OR=5.860,95% CI 2.714-12.646)and carotid intima-media thickness(OR=9.918,95% CI 1.390-70.755)were independent risk factors for recurrent cerebral infarction(P<0.05).2.The plasma homocysteine levels in male patients with acute cerebral infarction M(P25,P75),21.3800(16.1050,37.5250)umol/L were significantly higher than those in female patients M(P25,P75),16.9100(12.5400,22.2500)umol/L,and the difference was statistically significant(P<0.05).The incidence of hyperhomocysteinemia in male patients was 79.4%,and that in female patients was 60.6%.The incidence of hyperhomocysteinemia in male patients was significantly higher than that in female patients,and the difference was statistically significant(P<0.05).3.The NIHSS score of the initial group was lower than that of the recurrent group on admission(P<0.05);The NIHSS score of the initial group was lower than that of the recurrent group on hospital discharge(P<0.05).The m RS score of patients in the initial group was lower than that of patients in the recurrence group on hospital discharge,and the difference was statistically significant(P<0.05).4.ROC curve analysis showed that the area under the ROC curve(AUC)of systolic blood pressure,plasma homocysteine level,carotid intima-media thickness and their combination were 0.674,0.632,0.631 and 0.718 respectively(P<0.05);and the sensitivity was 0.717,0.859,0.697 and 0.427;and the specificity was 0.562,0.416,0.547and0.577.5.Hypertension and hyperhomocysteinemia had positive synergistic effect on recurrence of cerebral infarction(S)= 3.79.Conclusion:1.In patients with ischemic stroke,H-type hypertension and carotid intima-media thickness are independent risk factors for recurrence of cerebral infarction.2.The plasma homocysteine level in patients with recurrent cerebral infarction was significantly higher than that in patients with primary cerebral infarction.The level of plasma Hcy and incidence of HHcy in male patients with cerebral infarction were higher than those in female patients.3.In patients with ischemic stroke,the symptoms of patients with recurrent cerebral infarction were more severe than those of patients with initial cerebral infarction,and the prognosis was worse.4.Systolic blood pressure,plasma homocysteine level,carotid intima-media thickness(IMT)and their combination have predictive value for recurrence of cerebral infarction.5.Hyperhomocysteinemia and hypertension have synergistic effect on recurrence of acute cerebral infarction.