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目的 探讨不同性别对高血压前期患者的脑、冠状动脉粥样硬化的影响。方法 收集心内科行冠脉造影检查（CAG）发现冠状动脉狭窄程度在30%~70%，仅接受药物治疗未行经皮冠脉介入（PCI）治疗的高血压前期患者243例，年龄在45~75岁，根据性别分为男性组140例和女性组103例，比较两组的临床特点、住院及访随期间用药情况，比较两组患者的高血压及心血管疾病（急性心肌梗死、缺血性脑卒中）发生情况。采用Cox多因素回归分析探讨年龄、性别、血脂等危险因素与高血压前期进展为高血压及心血管疾病发生的相关性。结果 两组患者基线资料比较，女性组的年龄显著高于男性组〔(61±7)岁vs.(59±7)岁，P<0.01〕，女性的血脂（总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇）水平也显著高于男性患者（均P<0.01），但是男性患者的血肌酐值、左室舒张期内径及具有吸烟、饮酒史的比例显著高于女性患者（均P<0.01）。经3.1~8.7(中位数4.5）年的随访后发现高血压前期患者中男性组有71人(50.7%)进展为高血压，而女性组有52人(50.5%)进展为高血压，两组差异无统计学意义。心血管疾病方面，两组共计有72名患者发生急性心肌梗死，其中男性组心肌梗死发生率显著高于女性组（37.1% vs. 19.4%，P<0.01），而女性组缺血性卒中发生率显著高于男性组（11.6% vs. 4.3%，P<0.05），高盐饮食的亚组中男性组35人发生急性心肌梗死，女性组仅13人，其男性的心肌梗死发生率高于女性组（50.7% vs. 25.5%，P<0.01）。为进一步探讨高血压及心血管疾病的危险因素，采用Cox多因素回归分析后发现，在高血压前期人群中，高盐饮食为高血压及心血管疾病独立的危险因素，高盐饮食为男性心血管疾病发生独立的危险因素（均P<0.05）。结论 在高血压前期人群中，高盐饮食会加重高血压及心血管疾病的发生及进展，尤其是男性患者，男性高血压前期人群发生急性心肌梗死危险更高，而女性组中缺血性卒中发生率更高。
Objective To investigate the effects of different genders on brain and coronary atherosclerosis in patients with prehypertension. Methods Totally 243 cases of prehypertensive patients who underwent percutaneous coronary intervention (PCI) who underwent percutaneous coronary intervention (PCI) were enrolled in the study. The coronary artery stenosis was detected in 30% ~ 70% 75 years old, divided into male group and female group according to gender, 140 cases were divided into two groups according to clinical characteristics, hospitalization and interviews with patients during the treatment of hypertension and cardiovascular disease (acute myocardial infarction, ischemia Stroke) occurred. Cox multivariate regression analysis was used to explore the correlation between risk factors such as age, gender, blood lipids and the progression of prehypertension to hypertension and cardiovascular disease. Results Compared with the baseline data of the two groups, the age of the female group was significantly higher than that of the male group [(61 ± 7) vs. (59 ± 7) years, P <0.01). The levels of total lipids (total cholesterol and low density lipoprotein cholesterol (P <0.01). However, the serum creatinine value, diastolic diameter of left ventricle and smoking and drinking history in male patients were significantly higher than those in female patients (all P & lt; ; 0.01). After 3.1 to 8.7 years of median follow-up of 4.5 years, 71 (50.7%) men in the prehypertensive group progressed to hypertension, while 52 (50.5%) women in the women group progressed to hypertension. Two There was no significant difference between groups. In cardiovascular disease, a total of 72 patients in both groups experienced acute myocardial infarction, with a significantly higher incidence of myocardial infarction in the male group than in the female group (37.1% vs. 19.4%; P <0.01), whereas ischemic stroke in the female group The incidence of MI in men was higher than that in men (11.6% vs. 4.3%, P <0.05). In the high-salt diet group, 35 were found to have acute myocardial infarction in males and 13 in females Female group (50.7% vs. 25.5%, P & lt; 0.01). To further explore the risk factors for hypertension and cardiovascular disease, Cox regression analysis showed that in the prehypertensive population, high-salt diet was an independent risk factor for hypertension and cardiovascular disease, while high-salt diet was male heart Vascular disease developed an independent risk factor (all P & lt; 0.05). Conclusion In the prehypertensive population, high-salt diet may aggravate the occurrence and progression of hypertension and cardiovascular disease. Especially in male patients, the risk of acute myocardial infarction is higher in pre-hypertensive men and ischemic stroke in female patients The incidence is higher.