Asmar R, Rudnichi A, Blacher J, London G M, Safar M E
L'institut CardioVasculaire, Paris, France.
Am J Hypertens. 2001 Feb;14(2):91-7. doi: 10.1016/s0895-7061(00)01232-2.
Pulse pressure (PP) and aortic pulse wave velocity (PWV) are significant markers of cardiovascular risk, but a similar role for central wave reflections has never been investigated.
To determine the factors influencing PP, PWV, and carotid wave reflections, a cohort of 1087 patients with essential hypertension either treated or untreated was studied cross-sectionally. Atherosclerotic alterations (AA) were defined on the basis of clinical events and PWV evaluated from an automatic device. The carotid amplification index (CAI), a quantitative estimation of the magnitude of central wave reflections, was measured noninvasively from pulse wave analysis using radial and carotid aplanation tonometry.
In the overall population, age and mean arterial pressure represented 30.4%, 32.3%, and 5.6% of the variance of, respectively PP, PWV, and CAI. For the latter, body weight and heart rate represented 22.9% of variability. On the basis of logistic regression, AA were associated, in addition to age, plasma creatinine and HDL cholesterol levels, and tobacco consumption to three mechanical factors, increased PP, increased PWV, and low diastolic blood pressure, but not by CAI (adjusted odds ratio: 1.00; 95% confidence intervals: 0.99-1.01).
In cross-sectional hypertensive populations, PP and PWV, but not CAI, are significantly and independently associated with cardiovascular amplications.
脉压（PP）和主动脉脉搏波速度（PWV）是心血管风险的重要标志物，但中心波反射的类似作用从未被研究过。
为了确定影响PP、PWV和颈动脉波反射的因素，对1087例接受治疗或未接受治疗的原发性高血压患者进行了横断面研究。根据临床事件定义动脉粥样硬化改变（AA），并使用自动装置评估PWV。颈动脉放大指数（CAI）是对中心波反射幅度的定量估计，通过使用桡动脉和颈动脉压平式眼压计进行脉搏波分析无创测量。
在总体人群中，年龄和平均动脉压分别占PP、PWV和CAI方差的30.4%、32.3%和5.6%。对于后者，体重和心率占变异性的22.9%。基于逻辑回归，除了年龄、血浆肌酐和高密度脂蛋白胆固醇水平以及吸烟外，AA还与三个机械因素相关，即PP升高、PWV升高和舒张压降低，但与CAI无关（调整后的优势比：1.00；95%置信区间：0.99 - 1.01）。
在横断面高血压人群中，PP和PWV而非CAI与心血管并发症显著且独立相关。
