1
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Xiao K, Xv Z, Xv Y, Wang J, Xiao L, Kang Z, Zhu J, He Z, Huang G. H-type hypertension is a risk factor for chronic total coronary artery occlusion: a cross-sectional study from southwest China. BMC Cardiovasc Disord 2023; 23:301. [PMID: 37328790 PMCID: PMC10273712 DOI: 10.1186/s12872-023-03345-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Chronic total coronary occlusion (CTO) is serious and the "last bastion" of percutaneous coronary intervention. Hypertension and hyperhomocysteinemia (HHCY) are synergistic and significantly increase cardiovascular event risk. The relationship between H-type hypertension and CTO remains unclear; thus, this cross-sectional study investigated this potential association. METHODS Between January 2018 and June 2022, 1446 individuals from southwest China were recruited to participate in this study. CTO was defined as complete coronary artery occlusion persisting for over three months. H-type hypertension was defined as hypertension with plasma homocysteine levels ≥ 15 µmol/L. Multivariate logistic regression models were applied to assess the association between H-type hypertension and CTO. Receiver operating characteristic (ROC) curves were generated to determine the accuracy of H-type hypertension in predicting CTO. RESULTS Of the 1446 individuals, 397 had CTO, and 545 had H-type hypertension. After multivariate adjustment, the odds ratio (OR) for CTO in individuals with H-type hypertension was 2.3-fold higher (95% CI 1.01-5.26) than that in healthy controls. The risk of CTO is higher in individuals with H-type hypertension than in those with isolated HHCY and hypertension. The area under the ROC curve for CTO was 0.685 (95% CI, 0.653-0.717) for H-type hypertension. CONCLUSIONS In southwest China, H-type hypertension is significantly related to the occurrence of CTO. TRIAL REGISTRATION This retrospective study was registered with the Chinese Clinical Trials Registry ( http://www.chictr.org.cn , ChiCTR2100050519.2.2).
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Affiliation(s)
- Kaiyong Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China.
| | - Zhe Xv
- Department of Pediatric Medicine, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Yuling Xv
- Sterilization Supply Center, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Jianping Wang
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Lian Xiao
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Zhou Kang
- Department of Medical Statistics, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Jianhui Zhu
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Zhongwei He
- Department of Cardiology, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
| | - Guan Huang
- Medical Laboratory Center, Guangyuan Central Hospital, 16 Jingxiangzi, Lizhou District, Guangyuan, 628017, Sichuan, China
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2
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Zhang D, Liu Z, Guo W, Lu Q, Zhang H, Lei Z, Liu P, Huang C, Wang J, Chang Q, Lin X, Wang F, Wu S. Serum homocysteine level is an independent risk factor for 1-year stroke recurrence in patients with acute ischemic stroke and H-type hypertension: results from the Xi'an stroke registry study of China. Front Neurol 2023; 14:1161318. [PMID: 37143996 PMCID: PMC10151713 DOI: 10.3389/fneur.2023.1161318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Background H-type hypertension has a high prevalence in China. However, the association of serum homocysteine levels with 1-year stroke recurrence in patients with acute ischemic stroke (AIS) and H-type hypertension has not been studied. Methods A prospective cohort study of patients with AIS admitted to hospitals between January and December 2015 in Xi'an, China, was conducted. Serum homocysteine levels, demographic data, and other relevant information were collected from all patients upon admission. Stroke recurrences were routinely tracked at 1, 3, 6, and 12 months after discharge. The blood homocysteine level was studied as a continuous variable and tertiles (T1-T3). A multivariable Cox proportional hazard model and a two-piecewise linear regression model were utilized to evaluate the association and ascertain the threshold effect regarding the serum homocysteine level and 1-year stroke recurrence in patients with AIS and H-type hypertension. Results Overall, 951 patients with AIS and H-type hypertension were enrolled, of whom 61.1% were male. After adjusting for confounders, patients in T3 had a significantly increased risk of recurrent stroke within 1 year, compared with those in T1 as the reference (hazard ratio = 2.24, 95% confidence interval: 1.01-4.97, p = 0.047). Curve fitting showed that serum homocysteine levels were positively curvilinearly correlated with 1-year stroke recurrence. Threshold effect analysis showed that an optimal threshold of serum homocysteine level <25 μmol/L was effective in reducing the risk of 1-year stroke recurrence in patients with AIS and H-type hypertension. Elevated homocysteine levels in patients with severe neurological deficits on admission significantly increased the risk of 1-year stroke recurrence (p for interaction = 0.041). Conclusions In patients with AIS and H-type hypertension, the serum homocysteine level was an independent risk factor for 1-year stroke recurrence. A serum homocysteine level of ≥25 μmol/L significantly increased the risk of 1-year stroke recurrence. These findings can inform the creation of a more precise homocysteine reference range for the prevention and treatment of 1-year stroke recurrence in patients with AIS and H-type hypertension and provide a theoretical foundation for the individualized prevention and treatment of stroke recurrence.
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Affiliation(s)
- Dandan Zhang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Zhongzhong Liu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Epidemiology and Biostatistics, School of Public Health of Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Weiyan Guo
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Qingli Lu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Huan Zhang
- College of Life Science, Northwest University, Xi'an, China
| | - Zhen Lei
- College of Life Science, Northwest University, Xi'an, China
| | - Pei Liu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Congli Huang
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Traditional Chinese Medicine, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Jing Wang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Qiaoqiao Chang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Xuemei Lin
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Fang Wang
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
| | - Songdi Wu
- Department of Neurology, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- Xi'an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi'an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China
- College of Life Science, Northwest University, Xi'an, China
- *Correspondence: Songdi Wu
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3
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Association between Twenty-Four-Hour Ambulatory Blood Pressure Variability and Cerebral Small Vessel Disease Burden in Acute Ischemic Stroke. Behav Neurol 2022; 2022:3769577. [DOI: 10.1155/2022/3769577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. This study is aimed at investigating the association between the twenty-four-hour ambulatory blood pressure variability monitoring (ABPM) and cerebral small vessel disease (cSVD) burden in acute ischemic stroke (AIS) patients. Methods. 115 AIS patients with demographics, vascular risk factors, 24 h ABPM, and brain magnetic resonance imaging (MRI) were retrospectively enrolled. 3.0 T MRI was used to assess cSVD burden by combining four MRI markers including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), perivascular spaces (PVS), and lacunes. Correlation analysis was conducted to detect whether ABPM was associated with cSVD burden in AIS patients. Results. 115 AIS patients with mean age
years and 75.7% male were enrolled in this study. 112 AIS patients (97.4%) had at least one cSVD marker. Spearman correlation analysis indicated that hypertension was positively correlated with cSVD burden (
,
). High-density lipoprotein (HDL) was negatively correlated with cSVD burden (
,
). Blood pressure variability such as 24 h mean SBP (
,
), day mean SBP (
,
), and night mean SBP (
,
) was positively correlated with higher cSVD burden. Ordinal logistic regression analysis demonstrated that higher 24 h SBP SD and day mean SBP were independent risk factors for cSVD after controlling for other confounders. Conclusions. Higher BPV was significantly related to total cSVD burden in AIS patients. 24 h SBP SD and day mean SBP were independent risk factors for cSVD burden in AIS patients but not DBP or DBP variability.
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4
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Wang J, Xi YX, Li JQ, Zhu WW. Gender difference in association between H-type hypertension and subcortical ischemic vascular disease. Front Aging Neurosci 2022; 14:998268. [PMID: 36247997 PMCID: PMC9560583 DOI: 10.3389/fnagi.2022.998268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background Subcortical ischemic vascular disease (SIVD) is a leading cause of vascular dementia. The present study tries to explore not only the gender-specific association between H-type hypertension and SIVD but also the indirect effects of H-type hypertension on cognition through the ischemic brain injury caused by SIVD. Materials and methods A total of 601 SIVD patients were included, comprising 322 males and 279 females. H-type hypertension was defined as hypertension accompanied with elevated serum total homocysteine (tHcy) level. The imaging manifestations of ischemic brain injury caused by SIVD were also evaluated, including white matter lesions (WML), lacunar infarction (LI) and brain atrophy (BA). Gender-specific subgroup analyses in association between H-type hypertension and SIVD were conducted, followed by a structural equation model based evaluation of the gender-specific mediating effects of SIVD on the relationship between H-type hypertension and cognition. Results For males, there was no noticeable difference in WML, LI and BA scores among control group, isolated hypertension group, isolated high tHcy group, and H-type hypertension group in most brain regions, but significant difference was found in all brain regions for females. Multiple regression analyses showed that H-type hypertension was significantly associated with WML, LI and BA for females, but not for males. For males, H-type hypertension mainly affected cognition through direct effect, while the H-type hypertension effect was mediated by ischemic brain injury caused by SIVD for females. Conclusion H-type hypertension was more closely related to SIVD for females than males, suggesting a gender-specific difference in association patterns between H-type hypertension and cognition.
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Affiliation(s)
- Juan Wang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yuan-Xue Xi
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Jia-Qi Li
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Wei-Wen Zhu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Wei-Wen Zhu,
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5
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Tu W, Yan F, Chao B, Ji X, Wang L. Status of hyperhomocysteinemia in China: results from the China Stroke High-risk Population Screening Program, 2018. Front Med 2021; 15:903-912. [PMID: 34893949 DOI: 10.1007/s11684-021-0871-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/29/2021] [Indexed: 12/31/2022]
Abstract
A nationwide survey was conducted from October 2018 to September 2019 to assess the prevalence of hyperhomocysteinemia (Hhcy) and its influencing factors in China. A standardized questionnaire was used to collect information. Hhcy was defined as the level of serum homocysteine (HCY) ⩾ 15.0µmol/L. The H-type hypertension (HHYP) was defined as hypertension with an elevated serum HCY 15.0µmol/L). Finally, 110 551 residents ⩾ 40 years of age from 31 provinces in the mainland of China were included. Overall, the median serum HCY level was 10.9µmol/L (interquartile range 7.9-15.1). A total of 28 633 participants (25.9%) were defined as Hhcy. The Hhcy prevalence ranged from 7.9% in Shanghai to 56.8% in Tianjin. The data showed that serum HCY levels were associated with age, male gender, cigarette smoking, hypertension, diabetes, ethnicity, endurance in exercise (inverse), and fruit and vegetable intake (inverse). In addition, 15 486 participants were defined as HHYP, and the rate was 14.0%. HHYP was an independent predictor of stroke with an adjusted odds ratio of 1.752 (95% CI 1.338-2.105). The geographical distribution pattern of the Hhcy epidemic reflects dynamic differences, and national strategies should be carried out to further improve the care of patients with Hhcy across China.
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Affiliation(s)
- Wenjun Tu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, 300192, China.,The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, 100053, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Baohua Chao
- The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, 100053, China
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
| | - Longde Wang
- The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, 100053, China.
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6
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Kong Y, Li X, Chang L, Liu Y, Jia L, Gao L, Ren L. Hypertension With High Homocysteine Is Associated With Default Network Gray Matter Loss. Front Neurol 2021; 12:740819. [PMID: 34650512 PMCID: PMC8505539 DOI: 10.3389/fneur.2021.740819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
Hypertension with high homocysteine (Hcy, ≥10 μmol/L) is also known as H-type hypertension (HHT) and proposed as an independent risk factor for stroke and cognitive impairment. Although previous studies have established the relationships among hypertension, Hcy levels, and cognitive impairment, how they affect brain neuroanatomy remains unclear. Thus, we aimed to investigate whether and to what extent hypertension and high Hcy may affect gray matter volume in 52 middle-aged HHT patients and 51 demographically matched normotensive subjects. Voxel-based morphological analysis suggested that HHT patients experienced significant gray matter loss in the default network. The default network atrophy was significantly correlated with Hcy level and global cognitive function. These findings provide, to our knowledge, novel insights into how HHT affects brain gray matter morphology through blood pressure and Hcy.
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Affiliation(s)
- Yanliang Kong
- Department of Radiology, People's Hospital of Tongchuan City, Tongchuan, China
| | - Xin Li
- Department of Ultrasound, People's Hospital of Tongchuan City, Tongchuan, China
| | - Lina Chang
- Department of Radiology, People's Hospital of Tongchuan City, Tongchuan, China
| | - Yuwei Liu
- Department of Radiology, People's Hospital of Tongchuan City, Tongchuan, China
| | - Lin Jia
- Department of Radiology, People's Hospital of Tongchuan City, Tongchuan, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lijuan Ren
- Department of Radiology, People's Hospital of Tongchuan City, Tongchuan, China.,Department of Ultrasound, People's Hospital of Tongchuan City, Tongchuan, China
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7
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Association between Plasma Homocysteine Concentrations and the First Ischemic Stroke in Hypertensive Patients with Obstructive Sleep Apnea: A 7-Year Retrospective Cohort Study from China. DISEASE MARKERS 2021; 2021:9953858. [PMID: 34621408 PMCID: PMC8492296 DOI: 10.1155/2021/9953858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
Purpose This study was aimed at investigating the association between baseline plasma homocysteine (Hcy) concentrations and the risk of the first ischemic stroke (IS) and at investigating any possible influential modifying factors in hypertensive patients with obstructive sleep apnea (OSA). Methods Cox proportional hazards regression was employed to investigate the relationship between plasma Hcy concentration and the first IS. A generalized additive model was applied to determine the nonlinear relationship. In addition, we conducted subgroup analysis. Results A total of 2350 hypertensive patients with OSA without a history of IS were enrolled in this study. At a median follow-up of 7.15 years, we identified 93 cases of the first IS. After adjusting for potential confounding, the findings revealed that plasma Hcy concentration was strongly and positively associated with the occurrence of the first IS (per SD increment; HR = 1.37, 95% CI: 1.30-1.44). A nonlinear relationship was found between plasma Hcy concentration and the risk of developing the first IS with inflection points for plasma Hcy of 5 μmol/L. In stratified analysis, a greater positive correlation was found between baseline plasma Hcy concentrations and new-onset IS in patients with DBP ≥ 90 mmHg (per SD increment; HR = 1.48, 95% CI: 1.33-1.65 vs. <90 mmHg: HR = 1.20, 95% CI: 1.02-1.42; P‐interaction = 0.04) and BMI ≥ 24 and <28 kg/m2 (per SD increment; HR = 1.46, 95% CI: 1.26-1.70 vs. <24 kg/m2: HR = 1.13, 95% CI: 0.95-1.33 vs. ≥28 kg/m2: HR = 1.46, 95% CI: 1.25-1.70; P‐interaction = 0.03). Conclusion Elevated plasma Hcy concentrations are independently associated with the risk of the first IS in hypertensive patients with OSA. Plasma Hcy concentrations ≥ 5 μmol/L surely increased the risk of the first IS in hypertensive patients with OSA.
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8
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Tan Y, Nie F, Wu G, Guo F, Wang Y, Wang L. Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound. J Atheroscler Thromb 2021; 29:492-501. [PMID: 33827997 PMCID: PMC9090480 DOI: 10.5551/jat.61275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim:
H-type hypertension is connected with carotid atherosclerotic plaques and stroke, whereas neovascularization is a dominant contributor to plaque vulnerability. However, the correlation between H-type hypertension and plaque vulnerability remains unclear. This study aims to explore the influence of H-type hypertension on intraplaque neovascularization (IPN).
Methods:
We enrolled 235 patients with carotid plaques into the investigation and classified them into four groups: H-type hypertension group, simple hypertension group, isolated hyperhomocysteinemia group, and control group. Contrast-enhanced ultrasound (CEUS) was performed on them and IPN was evaluated using semi-quantitative visual grading: grade 1 (no microbubbles or microbubbles limited to the adventitial side and/or shoulder of plaque) and, grade 2 (diffused microbubbles within plaque or microbubbles enter plaque core). To analyze the correlation between H-type hypertension and the degree of plaque enhancement, logistic regression was used.
Results:
Compared with those with CEUS grade 1 plaques, those with CEUS grade 2 plaques had higher frequency of ischemic stroke (29.0% vs. 45.1%,
P
<0.05), hypertension (41.0% vs. 56.3%,
P
<0.05), and H-type hypertension (18.0% vs. 29.6%,
P
<0.05). No significant differences existed in plaque morphology, plaque echogenicity, and the severity of carotid artery stenosis between the degree of plaque enhancement (all
P
>0.05). H-type hypertension (multivariate-adjusted OR: 3.036, 95% CI: 1.258–7.329) was independently connected with the degree of plaque enhancement even after adjusting for other covariates.
Conclusion:
H-type hypertension is expressly connected with the degree of plaque enhancement and may facilitate plaque vulnerability. Our findings may offer a new insight for treating vulnerable plaque, lowering blood pressure, and lowering homocysteine equally crucial.
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Affiliation(s)
- Yuting Tan
- Ultrasound Medical Center, Lanzhou University Second Hospital
| | - Fang Nie
- Ultrasound Medical Center, Lanzhou University Second Hospital
| | - Guode Wu
- Department of Neurology, Lanzhou University Second Hospital
| | - Fangzhou Guo
- Ultrasound Medical Center, Lanzhou University Second Hospital
| | - Yanqing Wang
- Ultrasound Medical Center, Lanzhou University Second Hospital
| | - Longli Wang
- Ultrasound Medical Center, Lanzhou University Second Hospital
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Huang K, Zhang Z, Huang S, Jia Y, Zhang M, Yun W. The association between retinal vessel abnormalities and H-type hypertension. BMC Neurol 2021; 21:6. [PMID: 33407217 PMCID: PMC7786500 DOI: 10.1186/s12883-020-02029-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background This study aimed to investigate the relationship between H-type hypertension and retinal vessel abnormalities. Methods Hypertensive patients were retrospectively enrolled in this study. According to plasma homocysteine (HCY), patients were divided into isolated hypertension and H-type hypertension groups. The diameter of retinal vessels and retinopathy were evaluated by retinal fundus photography. The differences of retinal vessel abnormalities between H-type hypertension and isolated hypertension were investigated by univariate and multivariate regression. Results A total of 191 hypertensive patients were included, of which 86 were with isolated hypertension and 105 with H-type hypertension. The H-type hypertension group had a higher ratio of retinopathy(P = 0.004) and higher degree of retinal arteriosclerosis (P = 0.005) than the isolated hypertension group. CRAE (107.47 ± 13.99µ m vs. 113.49 ± 11.72µ m, P = 0.002) and AVR (0.55 ± 0.06 vs. 0.58 ± 0.06, P = 0.001) were smaller in H-type hypertension group than those in isolated hypertension group. Multivariate analysis showed that after adjusting for age, sex, course of hypertension and diabetes, H-type hypertension was an independent risk factor of retinopathy (OR, 2.259; 95%CI, 1.165—4.378; P = 0.016), CRAE (β=-5.669; 95%CI, -9.452—-1.886; P = 0.004), and AVR (β=-0.023; 95%CI, -0.039—-0.007; P = 0.005). Conclusions H-type hypertension is closely related to more retinal vessel abnormalities than isolated hypertension. Controlling H-type hypertension may reduce the risk of small vascular damage.
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Affiliation(s)
- Kuankuan Huang
- Department of Neurology, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, Changzhou, 213004, Jiangsu, China
| | - Zhixiang Zhang
- Department of Neurology, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, Changzhou, 213004, Jiangsu, China
| | - Shan Huang
- Department of Neurology, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, Changzhou, 213004, Jiangsu, China
| | - Yanwen Jia
- Ophthalmology Department of Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, 213004, Changzhou, Jiangsu, China
| | - Min Zhang
- Department of Neurology, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, Changzhou, 213004, Jiangsu, China.
| | - Wenwei Yun
- Department of Neurology, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, No.29, Xinglong Lane, Tianning District, Changzhou, 213004, Jiangsu, China.
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