Chinese General Practice ›› 2024, Vol. 27 ›› Issue (08): 921-929.DOI: 10.12114/j.issn.1007-9572.2023.0540

• Original Research • Previous Articles     Next Articles

Correlation of Platelet Distribution Width with Different Hypertension Subtypes in Elderly Males and Females

  

  1. 1. Graduate School of North China University of Science and Technology, Tangshan 063000, China
    2. Graduate School of Hebei Medical University, Shijiazhuang 050000, China
    3. Graduate School of Hebei North University, Zhangjiakou 075000, China
    4. Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang 050000, China
  • Received:2023-07-18 Revised:2023-10-18 Published:2024-03-15 Online:2023-12-19
  • Contact: LI Gang

老年男性和女性血小板分布宽度与不同高血压亚型的相关性研究

  

  1. 1.063000 河北省唐山市,华北理工大学研究生学院
    2.050000 河北省石家庄市,河北医科大学研究生学院
    3.075000 河北省张家口市,河北北方学院研究生院
    4.050000 河北省石家庄市,河北省人民医院老年心血管科
  • 通讯作者: 李刚
  • 作者简介:
    作者贡献:王畅提出主要研究目标,负责研究的构思与设计,研究的实施,撰写论文;王畅、王林峰进行数据的收集与整理;王畅、权雅文、李刚进行统计学处理,图、表的绘制与展示;王畅、李刚进行论文的修订;李刚负责文章的质量控制与审查,对文章整体负责,监督管理。
  • 基金资助:
    国家自然科学基金资助项目(81370316)

Abstract:

Background

In recent years, the prevalence of hypertension among the elderly in China has been consistently increasing. Current studies have found some association between hypertension and platelets, and platelet distribution width serves as the most sensitive measure of platelet activation, therefore, this study was conducted to explore the relationship between platelet distribution width and hypertension in elderly males and females.

Objective

To investigate the correlation of platelet distribution width with various hypertension subtypes in the elderly males and females.

Methods

A total of 600 elderly hypertensive and elderly non-hypertensive patients aged 65 years and above who were hospitalized in the Department of Cardiovascular Medicine, Hebei Provincial People's Hospital between 1 January 2020 and 24 April 2023 were consecutively enrolled and classified into 150 cases in the simple systolic hypertension (ISH) group, 150 cases in the simple diastolic hypertension (IDH) group, 150 cases in the systolic-diastolic hypertension (SDH) group, 150 cases in the normotensive group based on hypertension measurements. Basic data of patients were collected, including age, gender, BMI, systolic blood pressure, diastolic blood pressure, creatinine, uric acid, total cholesterol, triacylglycerol, high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , fasting blood glucose, and platelet distribution width. Binary Logistic regression models were used to analyze the correlation between platelet distribution width and different hypertension subtypes.

Results

Binary Logistic regression analysis showed that age, uric acid, and platelet distribution width were influencing factors in the occurrence of ISH in males (P<0.05) ; age, BMI, total cholesterol, triacylglycerol, HDL-C, LDL-C, and platelet distribution width were influencing factors in the occurrence of IDH in males (P<0.05) . Moreover, BMI, uric acid, total cholesterol, triacylglycerol, HDL-C, LDL-C, platelet distribution width, and fasting blood glucose were identified as influencing factors in the occurrence of SDH in males (P<0.05) . BMI, total cholesterol, triacylglycerol, and platelet distribution width were influencing factors in the occurrence of ISH females (P<0.05) . BMI, triacylglycerol, HDL-C, and platelet distribution width were influencing factors in the occurrence of IDH in women (P<0.05) . BMI, total cholesterol, HDL-C, LDL-C, and platelet distribution width were influencing factors for the occurrence of SDH in women (P<0.05) . The sex-stratified analysis showed that, after adjusting for confounders such as age, BMI, creatinine, uric acid, total cholesterol, triacylglycerol, HDL-C, LDL-C, and fasting blood glucose, in males, the quartile 3 of platelet distribution width (>12.1-12.9 fL) was a risk factor for ISH (OR=8.893, 95%CI=2.731-28.955) , IDH (OR=5.265, 95%CI=1.758-15.768) , and SDH (OR=4.674, 95%CI=1.549-14.102) , while the quartile 4 of platelet distribution width (>12.9 fL) was a risk factor in the occurrence of SDH (OR=3.316, 95%CI=1.177-9.345) compared to quartile 1 of platelet distribution width (≤10.7 fL) ; in females, compared to quartile 1 of platelet distribution width (≤11.0 fL) , the quartile 3 of platelet distribution width (>12.4-13.2 fL) was a risk factor for ISH (OR=3.494, 95%CI=1.218-10.021) and SDH (OR=4.949, 95%CI=1.283-19.089) , quartile 4 of platelet distribution width (>13.2 fL) was a risk factor for ISH (OR=5.283, 95%CI=1.786-15.633) , IDH (OR=5.837, 95%CI=1.544-22.068) and SDH (OR=4.966, 95%CI=1.373-17.963) .

Conclusion

Among elderly males, platelet distribution width ≥12.1 fL is a risk factor for IDH and SDH. Among elderly women, platelet distribution width ≥12.4 fL is a risk factor for ISH and SDH, when platelet distribution width>13.2 fL, it is a risk factor for IDH.

Key words: Hypertension, Platelet distribution width, Simple systolic hypertension, Simple diastolic hypertension, Systolic-diastolic hypertension, Aged

摘要:

背景

近年来,我国老年人高血压患病率持续升高。现有研究发现高血压与血小板之间存在某种联系,而血小板分布宽度是衡量血小板活化最敏感的指标,因此探讨老年男性和女性血小板分布宽度与高血压之间的关系意义重大。

目的

探讨老年男性和女性血小板分布宽度与不同高血压亚型的相关性。

方法

连续入选2020-01-01—2023-04-24于河北省人民医院心血管内科住院的年龄≥65岁的老年高血压患者和老年非高血压患者600例,根据高血压测量结果,分为单纯收缩期高血压(ISH)组150例,单纯舒张期高血压(IDH)组150例,收缩-舒张期高血压(SDH)组150例,正常血压组150例。收集患者的一般资料,包括年龄、性别、BMI、收缩压、舒张压、肌酐、尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、血小板分布宽度。采用二元Logistic回归模型分析血小板分布宽度与不同高血压亚型的相关性。

结果

二元Logistic回归分析结果显示,年龄、尿酸、血小板分布宽度是老年男性ISH发生的影响因素(P<0.05);年龄、BMI、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板分布宽度是老年男性IDH发生的影响因素(P<0.05);BMI、尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板分布宽度、空腹血糖是老年男性SDH发生的影响因素(P<0.05)。BMI、总胆固醇、三酰甘油、血小板分布宽度是老年女性ISH发生的影响因素(P<0.05);BMI、三酰甘油、高密度脂蛋白胆固醇、血小板分布宽度是老年女性IDH发生的影响因素(P<0.05);BMI、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板分布宽度是老年女性SDH发生的影响因素(P<0.05)。性别分层分析显示,校正年龄、BMI、肌酐、尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖等混杂因素后,老年男性中,与血小板分布宽度第1四分位(≤10.7 fL)相比,血小板分布宽度第3四分位(>12.1~12.9 fL)发生ISH的风险为OR=8.893,95%CI=2.731~28.955;第3四分位发生IDH的风险为OR=5.265,95%CI=1.758~15.768;第4四分位(>12.9 fL)发生IDH的风险为OR=5.243,95%CI=1.870~14.705;第3四分位发生SDH的风险为OR=4.674,95%CI=1.549~14.102;第4四分位发生SDH的风险为OR=3.316,95%CI=1.177~9.345。老年女性中,与血小板分布宽度第1四分位(≤11.0 fL)相比,血小板分布宽度第3四分位(>12.4~13.2 fL)发生ISH的风险为OR=3.494,95%CI=1.218~10.021;第4四分位(>13.2 fL)发生ISH的风险为OR=5.283,95%CI=1.786~15.633;第4四分位发生IDH的风险为OR=5.837,95%CI=1.544~22.068;第3四分位发生SDH的风险为OR=4.949,95%CI=1.283~19.089;第4四分位发生SDH的风险为OR=4.966,95%CI=1.373~17.963。

结论

老年男性中,当血小板分布宽度≥12.1 fL时,是IDH、SDH的危险因素。老年女性中,当血小板分布宽度≥12.4 fL时,是ISH、SDH的危险因素;当血小板分布宽度>13.2 fL时,是IDH的危险因素。

关键词: 高血压, 血小板分布宽度, 单纯收缩期高血压, 单纯舒张期高血压, 收缩-舒张期高血压, 老年人