Analysis of changes in coronary arterial microcirculation index and its influencing factors in elderly patients with hypertension / 中华老年医学杂志

ABSTRACT

Objective@#To analyze the changes in coronary arterial microcirculation index and its possible influencing factors in elderly patients with hypertension.@*Methods@#In the retrospective case-control study, 36 elderly patients with hypertension in our hospital from May 2016 to April 2017 and meeting inclusion criteria were recruited as the hypertension group, and 36 matched non-hypertensive elderly patients during the same time were considered as the non-hypertensive group.Patients in the two groups underwent coronary angiography and percutaneous coronary function tests for the coronary heart disease symptoms such as chest pain and chest tightness.The changes of coronary microcirculation index were observed, and its possible influencing factors were analyzed in combination with other test results.@*Results@#The low-density lipoprotein level was lower, and plasma viscosity, erythrocyte sedimentation rate, serum high-sensitivity C-reactive protein and 24-h urinary protein were higher in the hypertension group than in the non-hypertensive group(P<0.05). The parameters were higher in the hypertension group versus in control group as follows Left ventricular ejection fractions(LVEF), [(74.82±6.71 )% vs.(71.56±4.93 )%], Left ventricular mass[(189.72±33.40)g vs.(174.38±29.11)g], Left ventricular mass index[(101.70±16.25)g/cm2 vs.(89.68±10.46)g/cm2](t=2.077, 3.731 and 4.676, P<0.05 or P<0.01), and the proportion of patients with decreased LVEF(52.8%, 19 cases vs.27.8% 10 cases, χ2=4.676). Multivariate logistic regression analysis showed that low-density lipoprotein(OR=2.887, 95%CI 1.754~8.193, P=0.035), plasma viscosity(OR=4.075, 95%CI 1.629~7.386, P=0.001), erythrocyte sedimentation rate(OR=3.534, 95%CI 1.293~6.730, P=0.001), serum high-sensitivity C-reactive protein(OR=2.821, 95%CI 1.546~7.386, P=0.001), 24-h urinary protein(OR=3.712, 95%CI 1.683~7.954, P=0.026), left ventricular mass index(OR=3.254, 95%CI 1.286~6.735, P=0.004)and reduced left ventricular diastolic function(OR=5.069, 95%CI 1.386~7.254, P=0.007)were the risk factors for abnormal changes in coronary microcirculation resistance index.@*Conclusions@#Elderly hypertensive patients have abnormal coronary microcirculation resistance index, and the intervention should be strengthened from the aspects of blood lipid, plasma viscosity, , inflammation, renal function and cardiac function, so as to improve coronary function and reduce adverse cardiovascular events.