Meaume S, Benetos A, Henry O F, Rudnichi A, Safar M E
Geriatrics Department of Charles-Foix Hospital, Limeil-Brevannes, France.
Arterioscler Thromb Vasc Biol. 2001 Dec;21(12):2046-50. doi: 10.1161/hq1201.100226.
Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease. Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested. A cohort of 141 subjects (mean+/-SD age, 87.1+/-6.6 years) was studied in 3 geriatrics departments in a Paris suburb. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured with a validated automatic device. During the 30-month follow-up, 56 patients died (27 from cardiovascular events). Logistic regressions indicated that age (P=0.005) and a loss of autonomy (P=0.01) were the best predictors of overall mortality. For cardiovascular mortality, aortic PWV was the major risk predictor (P=0.016). The odds ratio was 1.19 (95% confidence interval, 1.03 to 1.37). Antihypertensive drug treatment and blood pressure, including systolic and pulse pressure, had no additive role. In subjects 70 to 100 years old, aortic PWV is a strong, independent predictor of cardiovascular death, whereas systolic or pulse pressure was not. This prospective result will need to be confirmed in an intervention trial.
主动脉脉搏波速度（PWV）是原发性高血压患者和终末期肾病患者心血管死亡的重要且独立的预测指标。其对70至100岁人群心血管风险的影响尚未得到验证。在巴黎郊区的3个老年病科对141名受试者（平均年龄±标准差为87.1±6.6岁）进行了研究。除了测量血压计测量的血压外，还使用经过验证的自动设备测量主动脉PWV。在30个月的随访期间，56名患者死亡（27例死于心血管事件）。逻辑回归表明，年龄（P = 0.005）和生活不能自理（P = 0.01）是全因死亡率的最佳预测指标。对于心血管死亡率，主动脉PWV是主要的风险预测指标（P = 0.016）。比值比为1.19（95%置信区间为1.03至1.37）。降压药物治疗以及血压，包括收缩压和脉压，并无额外作用。在70至100岁的人群中，主动脉PWV是心血管死亡的强大独立预测指标，而收缩压或脉压则不是。这一前瞻性结果需要在干预试验中得到证实。
