Risk factor analysis of coronary heart disease in elderly patients with hypertension

doi:10.3760/cma.j.issn.1007-1245.2024.08.005

Abstract

Abstract:

Objective　This study aims to analyze the risk factors of coronary heart disease in elderly patients with hypertension. Methods　A total of 228 elderly hypertensive patients treated in the general outpatient department of Jinan Maternal and Child Health Hospital from January 2019 to January 2023 were included in this study. They were divided into two groups based on the coronary angiography results: a coronary heart disease group (125 cases) and a non-coronary heart disease group (103 cases). There were 64 males and 61 females in the coronary heart disease group, aged 67-80 (75.16±1.38) years. In the non-coronary heart disease group, there were 52 males and 51 females, aged 60-71 (64.53±1.26) years. The general data of all the patients were collected, and the severity of coronary lesions was assessed using the Gensini score. Full-day blood pressure monitoring was conducted, and the whole day blood pressure load was calculated using diastolic and systolic blood pressures. The myocardial perfusion reserve (MPR) was evaluated by cardiac magnetic resonance (CMR). The hemorheological indicators such as blood platelet parameters, blood lipids, fibrinogen, and plasma viscosity were measured. Ultrasound was used to compare the plaque detection rate, plaque index, and Coronary Artery Calcium Score (CACS) between the two groups. The differences in these indicators were compared, and multivariate logistic regression analysis was conducted to explore the risk factors of coronary heart disease in elderly patients with hypertension. Additionally, the correlations between these indicators and the Gensini score were analyzed by Pearson correlation analysis. Independent sample t test and χ² test were used. Results　Of the 228 hypertensive patients included, 125 had concurrent coronary heart disease. The Gensini score in the coronary heart disease group was significantly higher than that in the non-coronary heart disease group [(96.21±10.25) points vs. (21.03±3.36) points] (P<0.05). Multivariate logistic regression analysis showed that age, blood pressure load, MPR, mean platelet volume, hemorheological indicators, plaque index, and CACS were influencing factors for coronary heart disease in elderly hypertensive patients (all P<0.05). Additionally, the Gensini score was positively correlated with blood pressure load, plasma specific viscosity, plaque index, and CACS, and was negatively correlated with MPR (all P<0.05). Conclusion　Age, blood pressure load, MPR, platelet parameters, hemorheological indicators, plaque index, and CACS are all factors that influence elderly patients with hypertension complicated with coronary heart disease.

Key words:

Hypertension, Coronary heart disease, Coronary artery disease, Risk factors

摘要：

目的　本研究旨在分析老年高血压患者合并冠心病的危险因素。方法　纳入2019年1月至2023年1月济南市妇幼保健院全科门诊收治的老年高血压患者228例为研究对象，根据冠状动脉造影显示是否合并冠心病分为冠心病组（125例）和非冠心病组（103例）。冠心病组男64例，女61例，年龄67～80（75.16±1.38）岁；非冠心病组男52例，女51例，年龄60～71（64.53±1.26）岁。收集所有患者的一般资料，通过Gensini评分评估患者的冠脉病变程度；并对患者进行全天血压监测，通过舒张压和收缩压计算全天血压负荷值，通过心脏磁共振（CMR）评估心肌灌注储备（MPR）；测定患者血小板参数、血脂四项、纤维蛋白原、血浆比黏度等血液流变学指标。通过超声检查比较两组患者的斑块检出率、斑块指数和冠状动脉钙化积分（CACS）。比较两组患者各项指标的差异，通过多因素logistic回归分析探讨老年高血压患者合并冠心病的危险因素，并通过Pearson相关系数分析各项指标和Gensini评分的相关性。使用独立样本t检验、χ²检验。结果　共纳入228例高血压患者，其中合并冠心病125例，其Gensini评分显著高于非冠心病组［（96.21±10.25）分比（21.03±3.36）分］（P<0.05）；多因素logistic回归分析结果显示，年龄、血压负荷情况、MPR、平均血小板体积、血液流变学指标、斑块指数、CACS均是老年高血压患者合并冠心病的影响因素（均P<0.05）；Gensini评分与血压负荷情况、血浆比黏度、斑块指数和CACS均呈正相关，与MPR呈负相关（均P<0.05）。结论　年龄、血压负荷情况、MPR、血小板参数、血液流变学指标、斑块指数、CACS均是老年高血压患者合并冠心病的影响因素。

关键词:

高血压, 冠心病, 冠状动脉病变, 危险因素

Song Yunhong, Liu Yanan, Zhang Zongli.

Risk factor analysis of coronary heart disease in elderly patients with hypertension [J]. International Medicine and Health Guidance News, 2024, 30(8): 1253-1258.

宋云红刘亚楠张宗丽.

老年高血压患者合并冠心病的危险因素分析 [J]. 国际医药卫生导报, 2024, 30(8): 1253-1258.

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