强化降压治疗对老年高血压合并冠心病血脂相关指标的作用

Relationship between Lipid Factors and Enhanced Hypotension of Older Coronary Heart Disease with Multiple Branch Lesions

目的探究强化降压治疗对老年高血压合并冠心病血脂相关指标的影响,并评估预测冠脉病变严重程度的临床指标。方法纳入2021年1月至2023年1月期间1250例老年高血压合并冠心病患者,随机分为常规降压组和强化降压组。收集治疗前后空腹血脂水平,干预1个疗程后进行冠脉造影(coronary angiography,CAG)及Gensini(GS)评分。比较两组患者血脂相关指标及其比值,并分析其与GS评分的相关性。结果两组患者治疗后TG、TC、LDL-C均降低,HDL-C上升;且强化降压治疗组治疗后TC、LDL-C、TC/TG、LDL-C/HDL-C均低于常规降压治疗组,而TG/LDL-C高于常规降压治疗组,组间差异均有统计学意义(P<0.05),两组治疗后TG、HDL-C、VLDL-C差异无统计学意义(P>0.05)。多因素校正回归分析中,LDL-C/HDL-C与GS评分呈正相关(OR=1.442,95%CI:1.146~1.814,P<0.05)。结论与常规降压治疗相比,强化降压治疗后,老年高血压合并冠心病患者的TC、LDL-C、TC/TG、LDL-C/HDL-C均有显著下降,TG/LDL-C显著升高;老年高血压合并冠心病患者TC、LDL-C、TC/TG、LDL-C/HDL-C、TG/LDL-C与冠脉病变严重程度具有一定相关性,其中LDL-C/HDL-C可作为评估冠脉病变严重程度的临床指标。

Objective To investigate the effect of intensive antihypertensive treatment on lipid-related indexes of elderly hypertensive combined coronary heart disease,and to assess the clinical indexes for predicting the severity of coronary artery lesions.Methods A total of 1250 elderly patients with hypertension combined with coronary artery disease were included as study subjects from 2021.1 to 2023.1,and were randomly divided into conventional antihypertensive treatment group and intensive antihypertensive treatment group.Fasting blood lipids were collected before treatment,and at the end of 1 course of treatment,coronary angiography(CAG)and fasting blood lipids were detected,and the Gensini(GS)score was performed according to the results of CAG.We compared the lipid-related indexes of the two groups and analyzed the correlation between the lipid-related indexes,the ratio of the lipid-related indexes,and their correlation with the GS score.Results After treatment,TG,TC,LDL-C decreased and HDL-C increased in both groups of patients;After treatment,the levels of TC,LDL-C,TC/TG,and LDL-C/HDL-C in the intensified antihypertensive treatment group were lower than those in the conventional antihypertensive treatment group,while TG/LDL-C was higher than that in the conventional antihypertensive treatment group,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference in TG,HDL-C,and VLDL-C between the two groups after treatment(P>0.05).In multiple factor adjusted regression analysis,LDL-C/HDL-C was positively correlated with GS score(OR=1.442,95%CI:1.146-1.814,P<0.05).Conclusion Compared with conventional antihypertensive treatment,TC,LDL-C,TC/TG,LDL-C/HDL-C decreased significantly and TG/LDL-C increased significantly in elderly patients with hypertension combined with coronary artery disease after intensive antihypertensive treatment;there was a certain correlation between TC,LDL-C,TC/TG,LDL-C/HDL-C,TG/LDL-C,and the severity of coronary artery lesions in elderly patients with hypertension combined with coronary artery disease.LDL-C/HDL-C can be used as a clinical indicator to assess the severity of coronary artery lesions.