Effect of homocysteine, blood lipid level and carotid atherosclerosis on coronary heart disease in elderly patients with hypertension

Abstract

Objective To investigate the relationship among plasma homocysteine(Hcy), blood lipid levels and carotid atherosclerosis with coronary heart disease in elderly patients with hypertension. Methods A total of 300 elderly patients with hypertension(age>60 years) were selected as study objects, including 150 cases of coronary heart disease patients were diagnosed as CHD group, 150 cases of non coronary heart disease patients in the same period as the control group.Peripheral venous blood was extracted, the homocysteine and blood lipid levels were detected by automatic biochemiealanalyzer, and carotid artery ultrasound examination was performed to analyze the degree of carotid artery atherosclerosis, and the correlation analysis was performed. Results The plasma levels of Hcy in CHD group was significantly higher than the control group, the difference was statistically significant((23.36±6.06) x03BC;mol/L vs.(12.45±3.33) x03BC;mol/L, P<0.05). The levels of TG, TC, LDL-C in CHD group were significantly higher than that of the control group, the differences were statistically significant((2.32±0.37) mmol/L vs.(1.56±0.51) mmol/L, (6.45±0.44) mmol/L vs.(5.56±0.73) mmol/L, (4.12±0.76) mmol/L vs.2.98±0.56) mmol/L, P<0.001). The level of HDL-C in CHD group was significantly lower than the control group, the difference was statistically significant((1.54±0.45) mmol/L vs.(1.76±0.48) mmol/L, P<0.05). The carotid atherosclerosis occurrence rate in CHD group was higher than the control group, the difference was statistically significant(86.00%(129/150) vs.26.00%(39/150), P<0.001). The carotid artery type distribution of two groups was statistically significant(P<0.001). The plasma levels of Hcy with carotid atherosclerosis in CHD group were higher than the patients without carotid atherosclerosis, the difference was statistically significant((29.58±5.76) x03BC;mol/L vs.(16.75±4.24) x03BC;mol/L, t=2.328, P=0.026). Logistic regression showed that Hcy, blood lipid levels, carotid plaque may be the risk factors of coronary heart disease in elderly patients with hypertension. Conclusion High Hcy, high blood lipids and carotid plaque may be related to the occurrence of coronary heart disease in elderly patients with hypertension, the three may have a certain clinical value in predicting the occurrence of coronary heart disease in elderly patients with hypertension. Key words: Homocysteine; Blood lipids; Carotid artery atherosclerosis; Elderly essential hypertension; Coronary heart disease