Clinical Characteristics of Elderly Patients with Coronary Artery Disease and Hypertension and Its Relationship with All-cause Mortality
Objective To reveal the clinical characteristics of elderly patients with coronary artery disease and hypertension(CAD+HT)and its relationship with all-cause mortality based on a longitudinal cohort study with a large sample size from a single center.Method From 2008 to 2018,patients with coronary artery disease(CAD)who were admitted to our hospital and were aged over 65 years were selected for this study.These patients were followed up until September 2023.Through electronic medical records,comprehensive data were collected,including general demographic information,clinical biochemistry data,medical history,medications,and coronary interventional treatment details.Cox regression model was used to assess the hazard ratio for all-cause mortality outside the hospital and analyze the independent risk factors for all-cause mortality among patients with CAD+HT.Results This study included 10 947 elderly CAD patients,among whom 70.90％had hypertension.Patients with CAD+HT had higher levels of triglyceride,uric acid,fasting blood glucose and more diabetes,anemia,stroke,chronic kidney disease,hyperuricemia,peripheral artery disease,and atrial fibrillation compared to those with CAD alone.Over a median follow-up period of 6.63 years,1,562 cases of all-cause mortality occurred.Multivariate Cox regression model showed that patients with CAD+HT had a 17.00％increased risk of all-cause mortality compared to those with CAD alone(HR=1.17,95％CI:1.03-1.34).Additionally,age,heart rate,systolic blood pressure,smoking,diabetes mellitus,anemia,stroke,chronic kidney disease,heart failure,hyperuricemia,peripheral artery disease,valvular heart disease,myocardial infarction and diuretic were associated with an increased risk of long-term all-cause mortality among elderly patients with CAD+HT.Conclusion The proportion of hypertension is higher in elderly patients with CAD.Compared to those with CAD alone,patients with CAD+HT exhibit a greater number of cardiovascular disease-related risk factors and comorbidities.The long-term all-cause mortality risk is higher in patients with CAD+HT compared to those with CAD alone,although there is no significant difference in in-hospital mortality between the two groups.Age,heart rate,smoking,and most comorbidities are associated with all-cause mortality among patients with CAD+HT.
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