Objectives 1) To investigate the characteristics of blood pressure and its relationship with the incidence of cardiovascular event in patients with essential hypertension (EH) combining coronary heart disease (CHD);
2) To identify the relationship between serum uric acid (UA) and coronary heart disease as well as hypertension;
3) To explore the prediction of the combination serum uric acid level and left venticualr mass index (LVMI) in occurrence of cardiovascular events.
Methods The relationships between the coronary angiography diagnosis and clinical data were analysed with 546 essential-hypertensive patients who received coronary angiography. Blood pressure in all patients with EH or EH combining CHD was measured with ambulatory blood pressure monitoring (ABPM), patients were followed up for six months. The correlativity between parameters of ambulatory blood pressure and the risk of cardiovascular events were analysed. All patients underwent coronary angiography. The severity of coronary artery stenosis was evaluated by the number of impaired arteries and Gensini scores.
The levels of fasting plasma glucose (FPG), triglyeride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), serum uric acid (SUA), and serum creatinine (SCr) were measured by HITACHI 7080 automatic biochemistry analyzer in 546 patients with coronary heart disease and hypertension.
Results The incidence of cardiovascular event was higher in patients with essential hypertension (EH) combining coronary heart disease (CHD) than that in patients with EH. Age, Gensini scores, 24 h systolic blood pressure (SBP), day SBP, night SBP, 24 h pulse pressure (PP), day PP and night PP were higher in patients with EH combining CHD than that in patients with only EH. In the Logistic multivariate analysis, age, Gensini score, 24 h SBP and night PP were the best predictor for the incidence of cardiovascular event in patients with EH combining CHD.
Patients with essential hypertension combining coronary heart disease had strongly higher concentration of UA compared to that of patients with essential hypertention solely. The ratios of hyperuricemia concomitant hypercholesteremia and hypertriglyceridemia were significantly elevated than those of non-hyperuricemia concomitant hypercholesteremia and hypertriglyceridemia.
Conclusions Male, high salt intake, hypercholesterolemia and typic angina pectoris may be the predictors of the occurrence of cadiovascular disease for patients with essential hypertension combining caoronary heart disease. Age, Gensini scores, 24 h SBP and night PP were the risk factors for the incidence of cardiovascular event in patients with EH combining CHD. To control these factors might reduce the incidence of cardiovascular events. Hyperuricemia and LVMI has relationship with many risk factors for CHD and is an independent risk factor for incidence of hypertension with CHD.