Risk factor analysis of coronary heart disease in elderly patients with hypertension
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 x2 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.
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