BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to invest...BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.展开更多
As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among g...As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among geriatric patients is isolated systolic arterial hypertension (ISAH). The comparison of two ethnic groups of the population has showed higher levels of systolic and diastolic blood pressure (SBP and DBP) in the group of patients of non-indigenous nationality, rather than Yakut patients. Correlation was recorded in the group of non-indigenous patients as they age. Significant increase in the level of SBP was identified in the group of senile and long-livers than in the elderly. Detection of ECG signs of LVH showed the lowest specificity of Cornell voltage criterion comparing to Sokolow-Lyon criterion with its more often occurrence. ECG-signs of left ventricle hypertrophy are significantly more often established by Sokolow-Lyon criterion for men, Cornell voltage—for women. Correlation has been found between the presence of LVH and combination of Cornell voltage criterion with both Gubner-Ungerleider and Sokolow-Lyon criteria.展开更多
Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals ...Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals across the country,we extracted the medical data of the application of Danshen Ligustrazine Injection in the treatment of patients with coronary heart disease and hypertension.After normalization,the model was established by Apriori algorithm,and the association rules were analyzed by Clementine 12.0 software.Results:Most of the 1928 patients were between 75 and 90 years old(54.26%).There were more males than females,most with type 2 diabetes,cerebral infarction,etc.Each dose was more than 10 mL(52.78%).Aspirin enteric-coated tablets(67.63%),L-carnitine injection(58.77%),and atorvastatin calcium capsules(50.93%)were often used in combination with safflower yellow pigment(22.20%),Shexiang Baoxin Pill(16.55%),Suxiao Jiuxin Pill(15.09%);the most commonly used combination of western medicine was anticoagulant thrombolytic and antiplatelet drugs(85.84%),and the type of Chinese medicine was Huoxuehuayu(72.98%);The most common combination of two western medicines was L-carnitine injection+aspirin enteric-coated tablets,with a support of 41.9%;The most common combination of two Chinese and western medicines is western medicine·anti-anginal medicine+western medicine·anticoagulant thrombolytic and antiplatelet drugs with a support of 67.6%.Conclusion:Danshen Ligustrazine injection is mainly used in elderly patients with coronary heart disease and hypertension,with many comorbidities.The dosage standard needs to be optimized.The combination of drugs and guidelines should coordinate with each other,which provide clues for clinical diagnosis and treatment and optimization of medication.展开更多
The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were ...The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were enrolled from December 2016 to November 2017.They were randomly divided into two groups,33 patients in each group.Patients in the experimental group received nifedipine.In combination with enalapril,patients enrolled in the control group received nifedipine monotherapy.Compared with the control group,the total effective rate,serum nitric oxide(NO)after treatment,C-reactive protein(CRP)after treatment,homocysteine(HCY)after treatment,and blood pressure after treatment were significantly improved(P<0.05).There were no significant differences in serum NO,pre-treatment CRP,pre-treatment HCY,pre-treatment blood pressure,and adverse reactions during treatment between the two groups(P>0.05).The elderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.展开更多
Objective:To analyze the correlation between serum Hcy content and coronary atherosclerosis severity in patients with H-type hypertension and coronary heart disease. Methods: 48 patients with H-type hypertension and c...Objective:To analyze the correlation between serum Hcy content and coronary atherosclerosis severity in patients with H-type hypertension and coronary heart disease. Methods: 48 patients with H-type hypertension and coronary heart disease were selected as observation group, and 57 patients with normal hypertension and coronary heart disease were selected as control group. Echocardiography was used to determine coronary lesion parameters, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of homocysteine (Hcy) and coronary heart disease-related indexes, and the correlation between Hcy levels and coronary heart disease was further analyzed. Results:Serum Hcy level of observation group was higher than that of control group (P<0.05), absolute GLPSS value and E/A value under echocardiography were less than those of control group while E-DT and E/e value were higher than those of control group (P<0.05);serum adiponectin (APN) level was lower than that of control group while P-selectin, asymmetric dimethylarginine (ADMA), oxidized high-density lipoprotein (OX-HDL), MMP-2, MMP-9, lipoprotein-associated phospholipase A2 (Lp-PLA2) and Resistin levels were higher than those of control group (P<0.05);Hcy was negatively correlated with absolute GLPSS value, E/A value and APN level, and was positively correlated with E-DT value, E/e value as well as P-selectin, ADMA, OX-HDL, MMP-2, MMP-9, Lp-PLA2 and Resistin levels (P<0.05). Conclusions:There is direct correlation between serum Hcy levels and the severity of coronary heart disease in patients with H-type hypertension and coronary heart disease, it can be a reliable way to early screen for coronary heart disease and evaluate the illness, and it is also a new target of coronary heart disease intervention.展开更多
Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary hea...Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods:A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46) and observation group (n=46), and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment;Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01) μmol/L, (52.83±7.45)%] was significantly higher than the control group ((67.37±13.08) μmol/L, (49.47±6.96)%)Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the inflammatory stress, improve vascular endothelial function and left ventricular function of patients, has an important clinical value.展开更多
Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To exp...Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P 3 level in group B was statistically significantly lower than that in group A (P s = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P 3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P 3, the risk of hypertension increased (P 4, the risk of hypertension significantly increased (P 3 and FT4 are the influencing factors of hypertension. The lower the FT3 level, the higher the FT4 level, the higher the risk of hypertension. FT3 and FT4 may be potential biomarkers of depression in hypertensive patients. Thyroid function assessment is recommended in patients with hypertension.展开更多
Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT3DE). RT3DE data of ...Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT3DE). RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controis (NC) were acquired. Left ventricular end-diastolic volume (EDV) and left ventricular end-diastolic epicardial volume (EDVepi) were detected by RT3DE and two-dimensional echocardiography Simpson biplane method (2DE). LVRI (left ventricular mass/EDV) was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups (P〈0.01). There was no significant difference in NC group (P〉0.05), but significant difference in HHD and CAD intra-group (P〈0.05). There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups (t=0.69, P〈0.01; r=0.68, P〈0.01), but no significant correlation in CAD group (r=0.30, P〉0.05). It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.展开更多
Objective To investigate the combined effects of hypertension and angiotensinⅡon the risk of coronary heart disease(CHD)on the basis of a 10-year prospective study in an Inner Mongolian population of China.Methods Ba...Objective To investigate the combined effects of hypertension and angiotensinⅡon the risk of coronary heart disease(CHD)on the basis of a 10-year prospective study in an Inner Mongolian population of China.Methods Based on a cross-sectional survey,a prospective cohort study was conducted from June 2003 to July 2012 among 2,530 Mongolian people.展开更多
Objective Researching the features of insulin resistance in patients with coronary heart disease (CHD) . Methods The study included 20 healthy subjects (control group), 53 CHD patients without (Group A) and 24 with es...Objective Researching the features of insulin resistance in patients with coronary heart disease (CHD) . Methods The study included 20 healthy subjects (control group), 53 CHD patients without (Group A) and 24 with essential hypertension (Group B) . Oral glucose tolerance test was administered to all subjects. Venous blood samples were taken during fasting and at 30, 60, 120 and 180 min after the glucose load (100g). All samples were assayed for glucose, insulin and C - peptide. Results The glucose, insulin, and C - peptide curves were at a hierarchy of Group B > Group A > the control group. Insulin - sensitivity - index was at an inverse hierarchy (-4. 31±0.55, -4. 05±0.47, - 3. 82±0. 42, respectively) . The ratio of the area under the C - peptide to the insulin was at a hierarchy of control group (3. 84±0. 81)> Group A (2. 84±0. 93)> Group B (2.26±0. 67), P < 0. 01) . As to insulin and C - peptide releasing types, most subjects of the control group had common type, while the predominant response type was pure - high in Group A, delayed - and delayed - high in Group B. Conclusions There are insulin resistance, insulin - C - peptide separation and changes of insulin and C - peptide releasing types in CHD patients. Insulin resistance is more severe when with hypertension. The hyperinsulinemia in CHD might be due to the over - secretion of insulin, also due to slow clearance in the patients accompanied by hypertension.展开更多
AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with basel...AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with baseline circulating adiponectin measurements(n=1224)were analyzed prospectively at a mean of 3.8 years’follow-up,using continuous values or sex-specific tertiles.Total adiponectin was assayed by an ELISA kit.Type-2 diabetes was identified by criteria of the American Diabetes Association.Hypertension was defined as a blood pressure≥140 mmHg and/or≥90 mmHg and/or use of antihypertensive medication.Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders.RESULTS:In models of multiple linear regression,sex hormone-binding globulin,fasting insulin(inverse)and,in men,age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine.Cox regression analyses for incident coronary heart disease(CHD),adjusted for sex,age,non-HDL cholesterol,waist circumference and C-reactive protein,revealed significant inverse association with adiponectin tertiles in men but not women(HR=0.66;95%CI:0.32-1.38 for highest tertile).Cox regression for type-2 diabetes in a similar model(wherein glucose replaced non-HDL cholesterol),adiponectin tertiles appeared to protect in each gender.HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles(P-trend=0.67).CONCLUSION:High adiponectin levels failed to protect against the development of hypertension and,in women,against CHD,presumably paralleling impairment in renal function as well.Involvement of adiponectin in autoimmune complex with loss of antioxidative-antiatherogenic properties may be underlying.展开更多
Background:The cold winter weather in northern China influences the dietary habits of its residents,contributing to a heightened risk of cardiovascular disorders,such as hypertension and coronary heart disease.Key fac...Background:The cold winter weather in northern China influences the dietary habits of its residents,contributing to a heightened risk of cardiovascular disorders,such as hypertension and coronary heart disease.Key factors include low vegetable consumption and high salt and fat intakes.This study aims to investigate the relationships between northern dietary nutrient intake in northern China and cardiovascular disorders during the winter season.Methods:A food frequency questionnaire tailored to the actual eating habits in northern China was designed.Retrospective data from 955 Chinese adults were collected from November to March between 2014 to 2023.Logistic regression was employed to analyze the relationship between dietary nutrients and cardiovascular diseases,with model performance assessed using receiver operating characteristic(ROC)curves.Results:Adjusted for gender,age,and body mass index(BMI),an inverse association was observed between vitamin A(OR=0.706,95%CI:0.550,0.907),nicotinic acid(OR=0.584,95%CI:0.447,0.762),phosphorus(OR=0.777,95%CI:0.608,0.994),selenium(OR=0.719,95%CI:0.560,0.923),zinc(OR=0.683,95%CI:0.531,0.880),methionine(OR=0.730,95%CI:0.569,0.936),arginine(OR=0.753,95%CI:0.588,0.964),lysine(OR=0.706,95%CI:0.550,0.907),aspartic acid(OR=0.730,95%CI:0.569,0.936)and hypertension.Additionally,a negative association was found between niacin(OR=0.752,95%CI:0.597,0.946)and coronary heart disease.Conversely,a positive association was identified between iodine and hypertension(OR=1.305,95%CI:1.020,1.669)and coronary heart disease(OR=1.301,95%CI:1.037,1.634).Conclusion:Our study suggests that maintaining a balanced dietary intake of vitamin A,niacin,phosphorus,selenium,zinc,methionine,arginine,lysine,and aspartic acid can be beneficial in preventing hypertension.Adequate niacin intake is associated with a lower risk of coronary heart disease.However,excessive iodine intake may contribute to hypertension and coronary heart disease.展开更多
Background: The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the pr...Background: The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF. Methods: This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD. Results: The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age;to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2 DS 2 -VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions: AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.展开更多
基金Supported by National Natural Science Foundation of China(General Program),No.82070631.
文摘BACKGROUND Clinical studies have reported that patients with gastroesophageal reflux disease(GERD)have a higher prevalence of hypertension.AIM To performed a bidirectional Mendelian randomization(MR)analysis to investi-gate the causal link between GERD and essential hypertension.METHODS Eligible single nucleotide polymorphisms(SNPs)were selected,and weighted median,inverse variance weighted(IVW)as well as MR egger(MR-Egger)re-gression were used to examine the potential causal association between GERD and hypertension.The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs.The MR-Egger intercept test,Cochran’s Q test and“leave-one-out”sen-sitivity analysis were performed to evaluate the horizontal pleiotropy,heterogen-eities,and stability of single instrumental variable.RESULTS IVW analysis exhibited an increased risk of hypertension(OR=1.46,95%CI:1.33-1.59,P=2.14E-16)in GERD patients.And the same result was obtained in replication practice(OR=1.002,95%CI:1.0008-1.003,P=0.000498).Meanwhile,the IVW analysis showed an increased risk of systolic blood pressure(β=0.78,95%CI:0.11-1.44,P=0.021)and hypertensive heart disease(OR=1.68,95%CI:1.36-2.08,P=0.0000016)in GERD patients.Moreover,we found an decreased risk of Barrett's esophagus(OR=0.91,95%CI:0.83-0.99,P=0.043)in essential hypertension patients.CONCLUSION We found that GERD would increase the risk of essential hypertension,which provided a novel prevent and therapeutic perspectives of essential hypertension.
文摘As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among geriatric patients is isolated systolic arterial hypertension (ISAH). The comparison of two ethnic groups of the population has showed higher levels of systolic and diastolic blood pressure (SBP and DBP) in the group of patients of non-indigenous nationality, rather than Yakut patients. Correlation was recorded in the group of non-indigenous patients as they age. Significant increase in the level of SBP was identified in the group of senile and long-livers than in the elderly. Detection of ECG signs of LVH showed the lowest specificity of Cornell voltage criterion comparing to Sokolow-Lyon criterion with its more often occurrence. ECG-signs of left ventricle hypertrophy are significantly more often established by Sokolow-Lyon criterion for men, Cornell voltage—for women. Correlation has been found between the presence of LVH and combination of Cornell voltage criterion with both Gubner-Ungerleider and Sokolow-Lyon criteria.
基金This study was supported by the Key Research and Development Program(No.2018YFC1707400)。
文摘Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals across the country,we extracted the medical data of the application of Danshen Ligustrazine Injection in the treatment of patients with coronary heart disease and hypertension.After normalization,the model was established by Apriori algorithm,and the association rules were analyzed by Clementine 12.0 software.Results:Most of the 1928 patients were between 75 and 90 years old(54.26%).There were more males than females,most with type 2 diabetes,cerebral infarction,etc.Each dose was more than 10 mL(52.78%).Aspirin enteric-coated tablets(67.63%),L-carnitine injection(58.77%),and atorvastatin calcium capsules(50.93%)were often used in combination with safflower yellow pigment(22.20%),Shexiang Baoxin Pill(16.55%),Suxiao Jiuxin Pill(15.09%);the most commonly used combination of western medicine was anticoagulant thrombolytic and antiplatelet drugs(85.84%),and the type of Chinese medicine was Huoxuehuayu(72.98%);The most common combination of two western medicines was L-carnitine injection+aspirin enteric-coated tablets,with a support of 41.9%;The most common combination of two Chinese and western medicines is western medicine·anti-anginal medicine+western medicine·anticoagulant thrombolytic and antiplatelet drugs with a support of 67.6%.Conclusion:Danshen Ligustrazine injection is mainly used in elderly patients with coronary heart disease and hypertension,with many comorbidities.The dosage standard needs to be optimized.The combination of drugs and guidelines should coordinate with each other,which provide clues for clinical diagnosis and treatment and optimization of medication.
文摘The objective of this study was to analyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.66 elderly patients with coronary heart disease and hypertension were enrolled from December 2016 to November 2017.They were randomly divided into two groups,33 patients in each group.Patients in the experimental group received nifedipine.In combination with enalapril,patients enrolled in the control group received nifedipine monotherapy.Compared with the control group,the total effective rate,serum nitric oxide(NO)after treatment,C-reactive protein(CRP)after treatment,homocysteine(HCY)after treatment,and blood pressure after treatment were significantly improved(P<0.05).There were no significant differences in serum NO,pre-treatment CRP,pre-treatment HCY,pre-treatment blood pressure,and adverse reactions during treatment between the two groups(P>0.05).The elderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.
文摘Objective:To analyze the correlation between serum Hcy content and coronary atherosclerosis severity in patients with H-type hypertension and coronary heart disease. Methods: 48 patients with H-type hypertension and coronary heart disease were selected as observation group, and 57 patients with normal hypertension and coronary heart disease were selected as control group. Echocardiography was used to determine coronary lesion parameters, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of homocysteine (Hcy) and coronary heart disease-related indexes, and the correlation between Hcy levels and coronary heart disease was further analyzed. Results:Serum Hcy level of observation group was higher than that of control group (P<0.05), absolute GLPSS value and E/A value under echocardiography were less than those of control group while E-DT and E/e value were higher than those of control group (P<0.05);serum adiponectin (APN) level was lower than that of control group while P-selectin, asymmetric dimethylarginine (ADMA), oxidized high-density lipoprotein (OX-HDL), MMP-2, MMP-9, lipoprotein-associated phospholipase A2 (Lp-PLA2) and Resistin levels were higher than those of control group (P<0.05);Hcy was negatively correlated with absolute GLPSS value, E/A value and APN level, and was positively correlated with E-DT value, E/e value as well as P-selectin, ADMA, OX-HDL, MMP-2, MMP-9, Lp-PLA2 and Resistin levels (P<0.05). Conclusions:There is direct correlation between serum Hcy levels and the severity of coronary heart disease in patients with H-type hypertension and coronary heart disease, it can be a reliable way to early screen for coronary heart disease and evaluate the illness, and it is also a new target of coronary heart disease intervention.
文摘Objective: To investigate the effect of telmisartan combined with Nifedipine Controlled Release Tablet on inflammatory factors, vascular endothelial function and left ventricular function in patients with coronary heart disease with mild to moderate hypertension. Methods:A total of 92 cases of patients with coronary heart disease with mild to moderate hypertension were selected as the object of observation, according to the random data table, they were divided into the control group (n=46) and observation group (n=46), and patients in the control group were treated with Nifedipine Controlled Release Table therapy, on this basis, the observation group patients were given telmisartan treatment, two groups were treated for 6 months. The levels of the blood pressure, inflammatory factors, vascular endothelial function and left ventricular function compared between the two groups before and after treatment. Results: There were no significant differences in the levels of SBP, DBP, hs-CRP, TNF-α, NO, ET-1, LVEF, LVEDD and LVESD in the two groups before treatment. After treatment, two groups of SBP, DBP, hs-CRP, TNF-α, ET-1, LVEDD and LVESD levels were significantly lower than those in the same group before treatment, and after treatment, the levels of SBP, DBP, hs-CRP, TNF-α, ET-1 and LVESD in the observation group were significantly lower than those in the control group, while there were no significant difference in the level of LVEDD between the two groups after treatment;Compared with level in the group before treatment, the levels of NO and LVEF in the two groups were significantly increased, and the observation group [(82.13±19.01) μmol/L, (52.83±7.45)%] was significantly higher than the control group ((67.37±13.08) μmol/L, (49.47±6.96)%)Conclusion: Telmisartan combined with Nifedipine Controlled Release Table in treating coronary heart disease with mild to moderate hypertension, can effectively control blood pressure, reduce the inflammatory stress, improve vascular endothelial function and left ventricular function of patients, has an important clinical value.
文摘Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P 3 level in group B was statistically significantly lower than that in group A (P s = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P 3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P 3, the risk of hypertension increased (P 4, the risk of hypertension significantly increased (P 3 and FT4 are the influencing factors of hypertension. The lower the FT3 level, the higher the FT4 level, the higher the risk of hypertension. FT3 and FT4 may be potential biomarkers of depression in hypertensive patients. Thyroid function assessment is recommended in patients with hypertension.
文摘Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT3DE). RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controis (NC) were acquired. Left ventricular end-diastolic volume (EDV) and left ventricular end-diastolic epicardial volume (EDVepi) were detected by RT3DE and two-dimensional echocardiography Simpson biplane method (2DE). LVRI (left ventricular mass/EDV) was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups (P〈0.01). There was no significant difference in NC group (P〉0.05), but significant difference in HHD and CAD intra-group (P〈0.05). There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups (t=0.69, P〈0.01; r=0.68, P〈0.01), but no significant correlation in CAD group (r=0.30, P〉0.05). It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.
文摘Objective To investigate the combined effects of hypertension and angiotensinⅡon the risk of coronary heart disease(CHD)on the basis of a 10-year prospective study in an Inner Mongolian population of China.Methods Based on a cross-sectional survey,a prospective cohort study was conducted from June 2003 to July 2012 among 2,530 Mongolian people.
文摘Objective Researching the features of insulin resistance in patients with coronary heart disease (CHD) . Methods The study included 20 healthy subjects (control group), 53 CHD patients without (Group A) and 24 with essential hypertension (Group B) . Oral glucose tolerance test was administered to all subjects. Venous blood samples were taken during fasting and at 30, 60, 120 and 180 min after the glucose load (100g). All samples were assayed for glucose, insulin and C - peptide. Results The glucose, insulin, and C - peptide curves were at a hierarchy of Group B > Group A > the control group. Insulin - sensitivity - index was at an inverse hierarchy (-4. 31±0.55, -4. 05±0.47, - 3. 82±0. 42, respectively) . The ratio of the area under the C - peptide to the insulin was at a hierarchy of control group (3. 84±0. 81)> Group A (2. 84±0. 93)> Group B (2.26±0. 67), P < 0. 01) . As to insulin and C - peptide releasing types, most subjects of the control group had common type, while the predominant response type was pure - high in Group A, delayed - and delayed - high in Group B. Conclusions There are insulin resistance, insulin - C - peptide separation and changes of insulin and C - peptide releasing types in CHD patients. Insulin resistance is more severe when with hypertension. The hyperinsulinemia in CHD might be due to the over - secretion of insulin, also due to slow clearance in the patients accompanied by hypertension.
文摘AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with baseline circulating adiponectin measurements(n=1224)were analyzed prospectively at a mean of 3.8 years’follow-up,using continuous values or sex-specific tertiles.Total adiponectin was assayed by an ELISA kit.Type-2 diabetes was identified by criteria of the American Diabetes Association.Hypertension was defined as a blood pressure≥140 mmHg and/or≥90 mmHg and/or use of antihypertensive medication.Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders.RESULTS:In models of multiple linear regression,sex hormone-binding globulin,fasting insulin(inverse)and,in men,age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine.Cox regression analyses for incident coronary heart disease(CHD),adjusted for sex,age,non-HDL cholesterol,waist circumference and C-reactive protein,revealed significant inverse association with adiponectin tertiles in men but not women(HR=0.66;95%CI:0.32-1.38 for highest tertile).Cox regression for type-2 diabetes in a similar model(wherein glucose replaced non-HDL cholesterol),adiponectin tertiles appeared to protect in each gender.HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles(P-trend=0.67).CONCLUSION:High adiponectin levels failed to protect against the development of hypertension and,in women,against CHD,presumably paralleling impairment in renal function as well.Involvement of adiponectin in autoimmune complex with loss of antioxidative-antiatherogenic properties may be underlying.
基金This research was supported by the National Natural Science Foundation of China(82273613)Heilongjiang Provincial Natural Science Foundation of China(LC2016032).
文摘Background:The cold winter weather in northern China influences the dietary habits of its residents,contributing to a heightened risk of cardiovascular disorders,such as hypertension and coronary heart disease.Key factors include low vegetable consumption and high salt and fat intakes.This study aims to investigate the relationships between northern dietary nutrient intake in northern China and cardiovascular disorders during the winter season.Methods:A food frequency questionnaire tailored to the actual eating habits in northern China was designed.Retrospective data from 955 Chinese adults were collected from November to March between 2014 to 2023.Logistic regression was employed to analyze the relationship between dietary nutrients and cardiovascular diseases,with model performance assessed using receiver operating characteristic(ROC)curves.Results:Adjusted for gender,age,and body mass index(BMI),an inverse association was observed between vitamin A(OR=0.706,95%CI:0.550,0.907),nicotinic acid(OR=0.584,95%CI:0.447,0.762),phosphorus(OR=0.777,95%CI:0.608,0.994),selenium(OR=0.719,95%CI:0.560,0.923),zinc(OR=0.683,95%CI:0.531,0.880),methionine(OR=0.730,95%CI:0.569,0.936),arginine(OR=0.753,95%CI:0.588,0.964),lysine(OR=0.706,95%CI:0.550,0.907),aspartic acid(OR=0.730,95%CI:0.569,0.936)and hypertension.Additionally,a negative association was found between niacin(OR=0.752,95%CI:0.597,0.946)and coronary heart disease.Conversely,a positive association was identified between iodine and hypertension(OR=1.305,95%CI:1.020,1.669)and coronary heart disease(OR=1.301,95%CI:1.037,1.634).Conclusion:Our study suggests that maintaining a balanced dietary intake of vitamin A,niacin,phosphorus,selenium,zinc,methionine,arginine,lysine,and aspartic acid can be beneficial in preventing hypertension.Adequate niacin intake is associated with a lower risk of coronary heart disease.However,excessive iodine intake may contribute to hypertension and coronary heart disease.
基金Capital Health Research and Development of Special,Beijing Health Commission(No.2020-2-5013)National Natural Science Foundation of China(No.82070433)
文摘Background: The clinical characteristics of patients with the comorbidities of hypertension and coronary artery disease (HT-CAD) and atrial fibrillation (AF) are largely unknown. This study aimed to investigate the prevalence of AF in patients with HT-CAD and clinical characteristics of patients with both HT-CAD and AF. Methods: This cross-sectional study was conducted in Chinese People’s Liberation Army General Hospital in Beijing, China, and included 20,747 inpatients with HT-CAD with or without AF from August 2008 to July 2018. We examined the overall prevalence, clinical characteristics, comorbidity profiles, treatment patterns, and blood pressure (BP) control of patients with both HT-CAD and AF. Multivariate logistic regression was used to investigate the associations of cardiovascular risk factors with AF in patients with HT-CAD. Results: The overall prevalence of AF in patients with HT-CAD was 4.87% (1011/20,747), and this increased with age;to be specific, the prevalence in women and men increased from 0.78% (2/255) and 1.02% (26/2561) at the age of <50 years to 8.73% (193/2210) and 10.28 % (298/2900) at the age of ≥70 years, respectively. HT-CAD patients who had AF had a higher prevalence of cardiovascular-related comorbidities than those without AF. Multivariate logistic regression showed that age, gender (male), body mass index, heart failure, and chronic kidney disease were independently associated with the risk of AF in patients with HT-CAD. For those with both HT-CAD and AF, 73.49% (743/1011) had a CHA 2 DS 2 -VASc score of ≥4, and only about half of them had the BP controlled at <140/90 mmHg, which indicated a high risk of thromboembolism and stroke. The use of oral anticoagulation increased during the study period (10.00% [20/200] in 2008 to 2011 vs. 30.06% [159/529] in 2015 to 2018, P < 0.01), but remained at a relatively low level. Conclusions: AF is highly prevalent among patients with HT-CAD. Patients with both HT-CAD and AF have a higher prevalence of cardiovascular-related comorbidities, lower BP control rate, and lower use of oral anticoagulation.