Abstract:

Objective To investigate the influence of plasma homocysteine（Hcy） levels on atherosclerosis in patients with H-type hypertension,and to investigate the related risk factors of atherosclerosis,in order to provide a reference for clinical treatment. Methods A total of 207 H-type hypertension patients,200 non-H-type hypertension patients and 200 healthy subjects（healthy control group） were enrolled. The blood pressure,serum Hcy level,total cholesterol（TC）,triglyceride（TG）,lipoprotein（a）[Lp（a）],uric acid（UA）and creatinine（Cr） were determined. Carotid ultrasound examination was performed. The patients were subclassified into 4 groups（H₁,H₂,H₃ and H₄） according to their serum Hcy levels. Results Serum levels of Lp（a） and Cr in H-type hypertension group were higher than those in non-H-type hypertension group and healthy control group（P<0.05）. Compared with healthy control group,the levels of TG and UA were higher in hypertension groups（P<0.05）. There was no statistical significance for the other 3 indicators among the 3 groups（P>0.05）. The proportion of severe hypertension in H-type hypertension group was higher than that in non-H-type hypertension group（P=0.02）,the intima-media thickness（IMT） was greater than that in non-H-type hypertension group（P=0.011）,and the incidence of atherosclerosis in H-type hypertension group was also higher（P=0.032）. The prevalence of atherosclerotic plaque and ITM showed statistical significance among H₁,H₂,H₃ and H₄ groups（P<0.05）. The high Hcy level [odds ratio（OR）=2.515,P=0.036],severe hypertension （OR=2.216,P=0.038） and high Lp（a） level（OR=2.189,P=0.041） were risk factors for atherosclerosis in patients with H-type hypertension. Conclusions H-type hypertension patients have high risk of atherosclerosis. While treating hypertension,regular monitoring of Hcy level is of significance for the treatment and prognosis of H-type hypertension.

Key words: H-type hypertension, Homocysteine, Atherosclerosis