Objective: To study characteristics of hypertension type H and provide reference for its prevention and treatment. Methods: A total of 482 patients with essential hypertension (EH) were selected from communities of Haidian or Daxing district. Patients with plasma homocysteine (Hey) ≥l5μmol/L was defined as patients with hypertension type H, and there were 353 patients with hypertension type H (hypertension type H group) and 129 patients with general EH (general EH group). Automatic pulse wave velocity (PWV) analyzer was used to measure carotid-femoral PWV (CF-PWV) and carotid- radial PWV (CR-PWV), and automatic biochemical analyzer was used to measure plasma Hey and biochemical indexes. Results: Compared with general EH group, there were significant increase in age [ (58. 7 ± 9. 5) years vs. (63. 9 ± 9. 6) years, P<0. 001], CF-PWV [10. 75 (7. 72~13. 78) m/s vs. 11.60 (8.60~14.60) m/s, P = 0.033], creatinine [ (64.4±15.5) mmol/L vs. (69. 5 ± 16. 6) mmol/L, P = 0. 003], uric acid [ (293.1 ± 73. 7) mmol/L vs. (310. 4 ± 70. 7) mmol/L, P = 0. 019] and percentage of males (39. 5% vs. 54. 1% , P = 0. 005), and significant decrease in fasting blood glucose [ (5.11 ± 0. 60) mmol/L vs. (4. 94 ± 0. 72) mmol/L, P = 0. 008] in hypertension type H group. Simple correlation analysis indicated that plasma Hey was positively correlated with age, creatinine, uric acid (r = 0. 181~0.282, P<0. 001 all) and CF-PWV (r = 0.114, P = 0. 012), and negatively correlated with high density lipoprotein cholesterol (HDL-C, r = - 0.112, P = 0. 014) in EH patients. Multiple factor stepwise regression analysis indicated that Hey was independent positively correlated with age (β = 0. 173, P<0.001) , creatinine (β = 0.146, P = 0. 012) and independent negatively correlated with female (β = - 0. 180, P = 0. 002). Conclusion: Hypertension type H possesses its own specific characteristics and higher cardiovascular risk, thus it should be paidrnmore attention .%目的:研究H型高血压的特点,为其防治提供参考.方法:从北京市海淀、大兴区社区人群中选择482名高血压病患者.以血浆同型半胱氨酸(Hcy)≥15μmol/L,定义为H型高血压,482例高血压患者中有H型高血压患者353例,普通高血压患者129例.采用自动脉搏波速度(PWV)分析仪测定颈一股动脉和颈一桡动脉PWV,全自动生化分析仪检测血浆Hcy及生化指标.结果:与普通型高血压患者比较,H型高血压患者年龄较大[(58.7±9.5)岁比(63.9±9.6)岁,P＜0.001],颈一股动脉PWV[10.75 (7.72～13.78) m/s比11.60 (8.60～14.60) m/s,P=0.033]、肌酐[(64.4±15.5) mmol/L比(69.5±16.6) mmol/L,P=0.003]、尿酸水平[(293.1±73.7) mmol/L比(310.4±70.7) mmol/L,P=0.019]明显升高,血糖水平明显降低[(5.11±0.60)mmol/L比(4.94±0.72)mmol/L,P=0.008],且男性较多(39.5％比54.1％,P=0.005).简单相关分析显示,高血压患者血浆Hcy与年龄、肌酐、尿酸(r=0.181～0.282,P均＜0.001)以及颈一股动脉PWV(r=0.114,P=0.012)呈正相关,而与HDL-C呈负相关(r=-0.112,P=0.014).多因素逐步回归分析显示,Hcy与年龄(β=0.173,P＜0.001)、肌酐(β=0.146,P=0.012)呈独立正相关,与女性呈独立负相关(β=-0.180,P=0.002).结论:H型高血压有自己的特点,具有更高的心血管风险,应当予以重视.
展开▼
