血脂相关指标对血压达标中老年高血压患者动脉僵硬度的影响

Effect of blood lipid related indexes on arterial stiffness in middle-aged and elderly hypertensive patients with blood pressure up to standard

目的观察血脂相关指标对血压达标的中老年高血压患者动脉僵硬度的影响。方法选择血压达标的中老年高血压患者168例,测量其肱踝脉搏波传导速度(baPWV),记录患者年龄、性别、体质量指数(BMI)、收缩压、既往病史、吸烟史、饮酒史、降脂药物用药情况及生化指标[空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、同型半胱氨酸(Hcy)、肌酐(CREA)、肾小球滤过率(eGFR)],计算非高密度脂蛋白胆固醇(non-HDL-C)、TC/HDL-C、TG/HDL-C、non-HDL-C/HDL-C。根据baPWV截点,比较动脉僵硬度正常及异常者的各项临床资料,二元Logistics回归分析各血脂指标对动脉僵硬度的影响。结果在168例血压达标的中老年高血压患者中,动脉僵硬度正常97例、异常71例。动脉僵硬度异常者年龄、收缩压、non-HDL-C、TG/HDL-C均高于正常者,吸烟、饮酒、男性比例和BMI、eGFR、HDL-C均低于正常者(P均<0.05),动脉僵硬度异常与正常者其余资料比较差异均无统计学意义(P均>0.05)。TG正常与异常者动脉僵硬度异常率分别为31.3%、49.5%,non-HDL-C正常与异常者动脉僵硬度异常率分别为30.7%、44.0%,TG/HDL-C正常与异常者动脉僵硬度异常率分别为29.5%、49.5%(P均<0.05)。二元Logistics回归分析结果显示,non-HDL-C(OR=7.183,95%CI:1.172~44.030)、TG/HDL-C(OR=1.460,95%CI:0.024~0.909)是血压达标的中老年高血压患者动脉僵硬度异常的危险因素(P均<0.05)。结论血脂相关指标中TG、non-HDL-C、TG/HDL-C异常的血压达标中老年高血压患者动脉僵硬度异常率升高,其中non-HDL-C、TG/HDL-C升高是其动脉僵硬度异常的危险因素。

Objective To observe the effect of blood lipid related indexes on arterial stiffness in middle-aged and elderly hypertensive patients with blood pressure up to standard.Methods A total of 168 middle-aged and elderly hypertensive patients with blood pressure up to standard were enrolled.The brachial-ankle pulse wave velocity(baPWV) was detected,and the age,sex,systolic blood pressure,body mass index(BMI),past history,smoking history,drinking history,lipid-lowering drugs and biochemical indexes [fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),uric acid(UA) and homocysteine(Hcy),creatinine(CREA),glomerular filtration rate(eGFR)] were recorded.Non-high density lipoprotein cholesterol(non-HDL-C),TC/HDL-C,TG/HDL-C,and non-HDL-C/HDL-Cwere calculated.According to the baPWV cut-off point,the clinical data of patients with normal arterial stiffness and abnormal arterial stiffness were compared,and Binary Logistics regression analysis was used to analyze the effect of various blood lipid indicators on arterial stiffness.Results In all 168 subjects,97 cases had normal arterial stiffness and 71 cases had abnormal arterial stiffness.Age,systolic blood pressure,non-HDL-Cand TG/HDL-C of patients with abnormal arterial stiffness were all higher than those of patients with normal arterial stiffness,while smoking,drinking,male proportion,BMI,eGFR and HDL-Cwere all lower(all P<0.05);other data had no statistical significance between two groups(P>0.05).The abnormal rates of arterial stiffness were 31.3% and 49.5% in patients with normal TG and abnormal TG,30.7% and 44.0% in patients with normal non-HDL-C and abnormal non-HDL-C,and 29.5% and 49.5% in patients with normal TG/HDL-C and abnormal TG/HDL-C,respectively(all P <0.05).Binary Logistics regression showed that non-HDL-C(OR=7.183,95%CI:1.172-44.030) and TG/HDL-C(OR=1.460,95%CI:0.024-0.909) were risk factors for abnormal arterial stiffness in middleaged and elderly hypertensive patients with blood pressure up to standard(both P <0.05).Conclusion In middle-aged and elderly hypertensive patients with blood pressure up to standard,the abnormal rate of arterial stiffness increases with abnormal TG,non-HDL-C and TG/HDL-C,and increased non-HDL-Cand TG/HDL-C are the risk factors for abnormal arterial stiffness.