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AIM: To analyze the effects of atorvastatin and folic acid tablets on homocysteine and carotid atherosclerosis in patients with type H hypertension. METHODS: A total of 140 patients with H-type hypertension admitted to our hospital from January 2016 to October 2018 were enrolled in the study. Random number table method was divided into observation group (70 cases) and control group (70 cases). The control group was treated with folic acid tablets on the basis of routine blood pressure reduction. The observation group was given atorvastatin calcium tablets on the basis of the control group, and the treatment was 10 weeks. Comparing the two groups of homocysteine, low-density lipoprotein, brachial-ankle pulse wave velocity, carotid intima-media thicknessbefore and after treatment, blood pressure and heart rate levels, and observed the occurrence of adverse reactions. During a follow-up of one year, the incidence of cardiovascular and cerebrovascular events was compared between the two groups. RESULTS:The plasma Hcy level and LDL level in the observation group was significantly lower than that in the control group (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). CONCLUSION:Atorvastatin combined with folic acid tablets can effectively reduce carotid atherosclerosis in patients with type H hypertension, and it can reduce the levels of Hcy and LDL, and it is clinically safe.
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Objective To investigate the correlation between type H hypertension and the development of coronary atherosclerosis.Methods From January 2015 to December 2016,three hundred and sixty patients with essential hypertension complicated with coronary atherosclerosis were treated in First Hospital of Shijiazhuang were selected,according to the level of serum homocysteine (Hcy),the patients were divided into the observation group (n =197 cases,Hcy ≥ 10 μ mol/L) and the control group (n =163 cases,Hcy＜10 μmol/L),all patients underwent coronary angiography and intravascular ultrasound.Results The cross-sectional area of extravascular elastic membrane (EEMCSA),plaque area (PA) and plaque burden(PB) of the observed group were (15.10±0.91) mm2,(8.80±0.99) mm2 and (62.03±3.20)％,wrere obviously higher than thoseat of the control group((13.72±0.96) mm2、(7.92±0.89) mm2、(56.87 ±3.37) ％),and the difference was statistically significant (t =14.079,、8.864,and 14.983,P＜0.05),and the minimum lumen cross section area (MLA) was (5.40 ±0.64) mm2,were obviously lower than that of the control group ((5.89 ± 0.52) mm2),and the difference was statistically significant (t =-7.937,P＜0.05);The Gensini score of the coronary artery in the observation group was (67.64± 13.19) points,which was significantly higher than that in the control group ((55.34± 12.20) points),and the difference was statistically significant (t =9.190,P＜0.05);the Serum Hcy were positively correlated with PA,PB and Gensini scores in the observation group (r =0.873,0.732and 0.856,P ＜ 0.05),which was negatively correlated with MLA (r =-0.773,P＜0.05).Conclusion There is a certain correlation between the severity of coronary atherosclerosis and the level of serum Hcy in patients with type H hypertension,which is worthy of further study.
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Objective To investigate the effect of folic acid and hypotensive drug on plasma homocysteine (Hcy),carotid atherosclerotic plaque and cerebral ischemic stroke in patients with type H hypertension.Methods A total of 300 patients with type H hypertension were randomly divided into control group and observation group,150 cases in each group.Eighty cases in the control group and twenty-six cases in the observation group were excluded during the follow-up period because of disobeying the doctor's advice or losing visits,132 cases in the control group and 124 cases in the observation group were rolled in this study at last.The patients in the control group were treated with conventional hypotensive drug.The patients in the observation group were treated with folic acid 2 mg orally,once a day for one year.The changes of blood pressure,plasma Hcy level,the carotid atherosclerosis and endpoint event were compared between the two groups.Results The systolic blood pressure(SBP) after 3 months of treatment was significantly lower than that after 6,9,and 12 months of treatment in the control group(P ＜ 0.05).The SBP after 12 months of treatment was significantly lower than that after 6 months of treatment in the control group(P ＜0.05).There was no statistic difference in the diastolic blood pressure(DBP) of patients at the time point of 3,6,9 months after treatment in the control group(P ＜0.05);the DBP of patients at the 12 months after treatment was significantly lower than that at the 3 months after treatment in the control group(P ＜0.05);there was no statistic difference in the DBP of patients at the 12 months after treatment and 6,9 months after treatment in the control group(P ＜ 0.05).The SBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P ＜0.05).The SBP after 9 and 12 months of treatment was significantly lower than that after 6 months of treatment in the observation group(P ＜0.05).The SBP after 12 months of treatment was significantly lower than that after 9 months of treatment in the observation group(P ＜ 0.05).The DBP after 6,9 and 12 months of treatment was significantly lower than that after 3 months of treatment in the observation group(P ＜0.05);but there was no significant difference in DBP between 6,9 and 12 months of treatment(P ＜0.05).The SBP and DBP in the observation group were significantly lower than those in the control group after 3,6,9 and 12 months of treatment(P ＜0.05).There was no significant difference in plasma Hcy level between the time points of 3,6,9 and 12 months of treatment(P ＜ 0.05).The plasma Hey level in the observation group decreased gradually after treatment,and there was significant difference between the different time points(P ＜ 0.05),and the plasma Hcy level in the observation group was significantly lower than that in the control group (P ＜ 0.05).There was no significant difference in carotid plaque detection rate and plaque stability between the two groups before treatment(x2 =0.303,0.422;P ＜ 0.05).Compared with before treatment,the carotid plaque detection rate decreased significantly (x2 =14.582,32.904;P ＜ 0.05),and the plaque stability increased significantly after 12 months of treatment in the two groups(x2 =35.352,12.878;P ＜ 0.05).Compared with the control group,the carotid plaque detection rate in the observation group decreased significantly(x2 =7.375,P ＜0.05),and the plaque stability increased significantly after 12 months of treatment(x2 =12.427,P ＜0.05).There was no significant difference in the intima-media thicknes(IMT),resistance index(RI) and plaque area between the two groups before treatment(P ＜0.05).The IMT,RI and plaque area after 12 months of treatment were significantly lower than those before treatment in the two groups(P ＜ 0.05);and the IMT,RI and plaque area in the observation group were significantly lower than those in the control group after 12 months of treatment (P ＜ 0.05).In the control group and the observation group,there were 17 cases(12.88) and 4 cases(3.23％) of stroke,7 cases(5.30％) and 4 cases(3.23％) of cardiovascular events,15 cases (11.36％) and 2 cases(1.61％) of death,respectively;the incidences of stroke and death in the observation group were significantly lower than those in the control group(x2 =7.912,9.805;P ＜0.05).There was no significant difference in the incidence of cardiovascular events between the two gmups(x2 =0.671,P ＜ 0.05).Conclusion Folic acid supplementation combined with antihypertensive treatment can significantly reduce the blood pressure and plasma Hey level,improve carotid atherosclerosis,and reduce the risks of stroke and death in patients with type H hypertension.
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Objective To observe the change of results of lipoprotein-associated phospholipase A2 (Lp-PLA2) ,homocysteine (Hcy ) ,high-sensitivity C-reactive protein (hs-CRP ) ,lipids and other indicators in the patients with normal group ,primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group ,and search the relationship between LP-PLA2 and type H-hypertension ischemic stroke .Methods From January 2015 to June 2017 ,continuous selected 103 patients with type H hypertension ischemic stroke group ,124 patients with type H hypertension group ,80 patients with primary hypertension group and 50 patients with healthy controls as normal group .Analyzed level of Lp-PLA2 ,Hcy ,hs-CRP and lipids in serum ,compared the difference with each group .A binary Logistic regression analysis was used to an-alyze its correlation with ischemic stroke .Results The serum concentration of total cholesterol(TC) ,low-den-sity lipoproteincholesterol(LDL-C) ,LP-PLA2 in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically significant(P＜0 .05) .The serum concentration of triglyceride (TG) in type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically signifi- cant(P＜0 .05) .The serum concentration of Hcy in primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group was higher than normal group ,the difference was statistically significant(P＜0 .05) ;The serum concentration of Hcy in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group ,the difference was statistically significant (P＜ 0 .05) ;The serum concentration of Hcy ,LP-PLA2 in type H hypertension ischemic stroke group was higher than type H hypertension group ,the difference was statistically significant (P＜0 .05) .The serum con-centration of hs-CRP in type H hypertension group was higher than primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) ;The serum concentration of hs-CRP in type H hy-pertension ischemic stroke group was higher than type H hypertension group ,primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) .Two element Logistic regression analysis , Lp-PLA2 were significantly related to type H hypertension ischemic stroke ( SE ＝ 0 .013 ,P ＜ 0 .05 ) . Conclusion LP-PLA2 is an inflammatory biomarker and it is closely related to the occurrence and develop-ment of type H hypertension ischemic stroke .
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Objective To investigate the therapeutic effect of Enalapril Maleate and Folic Acid Tablets in the treatment of type H hypertension complicated with coronary heart disease.MethodsA total of 80 patients with type H hypertension complicated with coronary heart disease admitted in our hospital from January 2014 to January 2016 were selected.They were randomly divided into control group and observation group.The control group was treated with enalapril maleate, while the observation group was treated with Enalapril Maleate and Folic Acid Tablets.The total effective rate of two groups of patients were analyzed and compared.ResultsAfter 6 months of treatment, the total effective rate of the observation group was significantly higher than that of the control group, the total effective rate of the observation group was 95.00%, and the total effective rate of the control group was 77.50%(P<0.05), the difference was statistically significant.ConclusionThe effect of Enalapril Maleate and Folic Acid Tablets in the treatment of type H hypertension complicated with coronary heart disease is obvious, and it can improve the total effective rate of the treatment.
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Objective To investigate the relationship between serum levels of ADMA ,CRP and atherosclerosis ,cardiovascular e-vents in patients with type H hypertension .Methods Totally 80 patients with type H hypertension from August 2012 to August 2015 in our hospital were selected ,80 cases of non H type essential hypertension patiens were recruited as control group ,enzyme linked immunosorbent assay (ELISA) was used to detect serum levels of ADMA and CRP ,and carotid atherosclerosis was evalua-ted by ultrasonography .All patients were followed up regularly to record the occurrence of cardiovascular events ,and to investigate the relationship between ADMA and CRP levels and atherosclerosis and cardiovascular events .Results The levels of ADMA ,CRP and the rate of atherosclerosis in patients with type H hypertension were higher than those in the control group ,the difference was statistically significant (P<0 .05) .There were 37 cases of atherosclerosis in patients with type H hypertension ,and the levels of ADMA and CRP in patients with atherosclerosis were higher than those in non atherosclerosis group ,and the difference was statis-tically significant (P<0 .05) .Logistic regression analysis indicated that mean arterial pressure and ADMA levels were independent risk factors for cardiovascular events in patients (P<0 .05) .Conclusion Serum levels of ADMA are closely related to atherosclero-sis ,and are independent risk factors for cardiovascular events in patients with type H hypertension .
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Objective To investigate the relationship between serum levels of ADMA ,CRP and atherosclerosis ,cardiovascular e-vents in patients with type H hypertension .Methods Totally 80 patients with type H hypertension from August 2012 to August 2015 in our hospital were selected ,80 cases of non H type essential hypertension patiens were recruited as control group ,enzyme linked immunosorbent assay (ELISA) was used to detect serum levels of ADMA and CRP ,and carotid atherosclerosis was evalua-ted by ultrasonography .All patients were followed up regularly to record the occurrence of cardiovascular events ,and to investigate the relationship between ADMA and CRP levels and atherosclerosis and cardiovascular events .Results The levels of ADMA ,CRP and the rate of atherosclerosis in patients with type H hypertension were higher than those in the control group ,the difference was statistically significant (P<0 .05) .There were 37 cases of atherosclerosis in patients with type H hypertension ,and the levels of ADMA and CRP in patients with atherosclerosis were higher than those in non atherosclerosis group ,and the difference was statis-tically significant (P<0 .05) .Logistic regression analysis indicated that mean arterial pressure and ADMA levels were independent risk factors for cardiovascular events in patients (P<0 .05) .Conclusion Serum levels of ADMA are closely related to atherosclero-sis ,and are independent risk factors for cardiovascular events in patients with type H hypertension .