Correlation of diastolic blood pressure and isolated systolic hypertension with coronary heart disease in the elderly / 中华老年医学杂志

ABSTRACT

Objective To investigate the correlation of diastolic blood pressure (DBP) ＜70mm Hg and isolated systolic hypertension (ISH) with coronary atherosclerosis (CAS) and coronary heart disease (CHD) in elderly patients and to analyze the independent risk factors for low DBP.Methods A total of 246 elderly patients with untreated ISH who underwent coronary angiography were divided into the low DBP group (n=102) and the non-low DBP group (n=144) according to DBP level.All clinical and angiographic data were collected and the retrospective analysis was performed to assess the risk of CAS and CHD in patients with low DBP and to analyze the risk factors for low DBP.Results There were no significant differences in systolic pressure level between the low DBP group and the non low DBP group [(156.2±15.6) mmHgvs.(154.4±14.2) mmHg,t=0.93,P＞0.05],while pulse pressure level was significantly higher in the low DBP group than in the non-lowDBPgroup [(91.3±±17.7) mmHgvs.(72.9±15.1) mm Hg,t=8.54,P＜0.01].Stepwise logistic analysis showed that age,diabetes and smoking were independent risk factors for low DBP.After adjustment for age,gender and other common risk factors,low DBP was independently associated with CAS and CHD (OR =1.72 and 1.44,95％ CI1.082.72 and 1.04-1.99,respectively,both P＜ 0.05).Conclusions Low DBP is independently associated with CAS and CHD in elderly patients with untreated ISH.Age,diabetes and smoking are the independent risk factors for low DBP.