Correlation between homocysteine, uric acid, ambulatory arterial stiffness index and left ventricular hypertrophy in elderly H-type hypertensive patients / 中国医师进修杂志

ABSTRACT

Objective To explore the correlation between homocysteine (Hcy), uric acid, ambulatory arterial stiffness index (AASI) and left ventricular hypertrophy (LVH) in elderly H-type hypertensive patients. Methods Two hundred and forty-one patients or outpatients with essential hypertension between September 2016 and June 2018 from the Department of Cardiology and Geriatrics of the First Affiliated Hospital of Jinzhou Medical University were selected, and they were 60 to 79 years old. In the patients, 191 cases had H-type hypertension (H-type hypertension group), and 50 cases had non-H-type hypertension patients (non-H-type hypertension group). In the H-type hypertension patients, LVH was in 78 cases, and non-LVH in 113 cases. The general clinical data were gathered, and the Hcy and uric acid were detected. The 24 h ambulatory blood pressure monitoring was performed in all patients, and the AASI was calculated. Results There were no statistical differences in the hypertension duration, uric acid, AASI and left ventricular mass index (LVMI) between H-type hypertension group and non-H-type hypertension group (P＞0.05). In elderly H-type hypertension patients, the hypertension duration in LVH patients was significantly longer than that in non-LVH patients (10.26 ± 3.95) years vs. (9.13 ± 3.05) years, the uric acid, AASI and Hcy were significantly higher than those in non-LVH patients (433.7 ± 65.7) μmol/L vs. (400.6 ± 67.5) μmol/L, 0.54 ± 0.11 vs. 0.49 ± 0.12 and (16.84 ± 4.70) μmol/L vs. (14.12 ± 2.26) μmol/L, and there were statistical differences (P＜0.05 or ＜0.01). Pearson correlation analysis result showed that the Hcy, uric acid and AASI had positive correlation with LVMI in elderly H-type hypertension patients (r = 0.56, 0.53 and 0.45; P＜0.01). Binary Logistic regression analysis result showed that Hcy was the independent risk factor of LVH in elderly H-type hypertension patients ( OR = 1.225, 95% CI 1.106 to 1.357, P = 0.000), but uric acid and AASI were not associated with LVH in elderly H-type hypertension patients (P＞0.05). Conclusions Hcy, uric acid and AASI are associated with LVH in elderly H-type hypertension patients, and Hcy is an independent risk factor of LVH, but uric acid and AASI are not independent risk factors of LVH. Hcy can be used as a predictor of LVH. Hcy screening and intervention should thus be strengthened.