老年高血压患者踝肱指数及其与冠心病、脑卒中相关性的研究

目的:了解老年高血压患者外周动脉性疾病(PAD)患病率及其特点,重点研究踝肱指数(ABI)与冠心病、脑卒中相关性的临床意义.方法:入选我院和安贞医院门诊及住院老年男性高血压患者,无损伤周围血管检查仪测定患者踝肱指数、标准问卷调查及各项指标测量确定患者身体基线状况;任一侧肢体ABI≤0.9诊断为PAD,1.01-1.30...

Association of ankle-brachial index with clinical coronary heart disease, stroke in aged Chinese hypertensive men

Objective：To assess the clinical significance of ankle-brachial index（ABI） in aged Chinese hypertensive men and to determine the association of ABI with clinical coronary heart disease,stroke.Methods：Ankle-brachial index（ABI） was measured by means of peripheral vascular lab in aged hypertensive men from 301 Hospital and Anzhen Hospital while the clinical characteristics of the study population were investigated and collected.ABI≤0.9 was defined as peripheral arterial disease（PAD）,1.01～1.30 as borderline PAD.Results：There were 244 aged Chinese hypertensive men with antihypertensive treatment and with mean age 76.47±9.75 enrolled in this study,in whom 15 men with missing data except general information and ABI measurement.The mean ABI was 0.941±0.258 with the highest frequency 1.01～1.30.Eighty five men were diagnosed as PAD,22 as borderline PAD,135 normal ABI and 2 with ABI1.3.ABI and rate of hypertension control in PAD and borderline PAD men were significantly lower than those with normal ABI. In both PAD and borderline PAD patients,the hypertension duration（except in borderline PAD）,creatinine level,neutrophil count（except in borderline PAD）,percentage of alcohol drin-king,prevalence of diabetes mellitus（except in borderline PAD）,coronary artery disease,stroke and dyslipidemia（except in borderline PAD） were significantly higher than those with normal ABI patients.The prevalences of PAD,borderline PAD,coronary artery di-sease and stroke in this study population were 35.1%,9.1%,64.0%,40.5%,respectively.The prevalences of PAD,borderline PAD,coronary artery disease and stroke increased significantly with increasing age.Logistic regression analysis showed that lower ABI was inversely associated with clinical coronary artery disease and stroke after adjustment for age,body mass index,hypertension duration,rate of hypertension control,systolic blood pressure,diastolic blood pressure,status of smoking,alcohol drinking,diabetes mellitus,dyslipidemia.The fully-adjusted odds ratios（ORs） for PAD and borderline PAD group compared with normal ABI group for the prevalence of coronary artery disease,and stroke demonstrated that these conditions were conversely related to ABI.Conclusion：Aged hypertensive men have high prevalence of PAD.Low ABI level was independently associated with coronary artery disease and stroke.