Benetos Athanase, Adamopoulos Chris, Bureau Jeanne-Marie, Temmar Mohamed, Labat Carlos, Bean Kathryn, Thomas Frédérique, Pannier Bruno, Asmar Roland, Zureik Mahmoud, Safar Michel, Guize Louis
Centre d'Investigations Préventives et Cliniques, Paris, France.
Circulation. 2002 Mar 12;105(10):1202-7. doi: 10.1161/hc1002.105135.
Elastic artery stiffness, a result of arterial aging, is an independent indicator of cardiovascular risk. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 6-year period in treated hypertensive subjects and normotensive subjects, and to evaluate the determinants of this progression.
Data for the present analysis were gathered from 483 subjects who had 2 health checkups at the Centre d'Investigations Préventives et Cliniques, the first one in 1992--1993 and the second one in 1998--1999. Carotid-femoral pulse wave velocity (PWV) was used to evaluate aortic stiffness in 187 hypertensive subjects who were under treatment at the time of the first visit and throughout the follow-up period, and in 296 subjects who were classified as normotensive during the first visit and who remained treatment-free throughout the follow-up period. In both populations, PWV progression was higher in older subjects. Annual rates of progression in PWV in treated hypertensives were significantly higher than in normotensives. Only treated hypertensives with well-controlled blood pressure levels at the time of both visits had a PWV progression similar to that of normotensives. In treated hypertensives, high heart rate and high creatinine during the first visit were associated with an accelerated progression in PWV.
The presence of high blood pressure, high heart rate, and high serum creatinine were the major determinants of accelerated progression of aortic stiffness in treated hypertensives. This is the first longitudinal study to evaluate the determinants of arterial aging over an extended period of time.
弹性动脉僵硬度是动脉老化的结果，是心血管风险的独立指标。本纵向研究的目的是比较治疗的高血压患者和血压正常者在6年期间主动脉僵硬度的进展情况，并评估这种进展的决定因素。
本分析的数据来自483名在预防与临床研究中心进行了两次健康检查的受试者，第一次检查在1992 - 1993年，第二次在1998 - 1999年。用颈股脉搏波速度（PWV）评估187名在首次就诊时正在接受治疗且在整个随访期间持续治疗的高血压患者，以及296名在首次就诊时被分类为血压正常且在整个随访期间未接受治疗的受试者的主动脉僵硬度。在这两个人群中，老年受试者的PWV进展更高。治疗的高血压患者PWV的年进展率显著高于血压正常者。只有在两次就诊时血压水平控制良好的治疗的高血压患者，其PWV进展与血压正常者相似。在治疗的高血压患者中，首次就诊时高心率和高肌酐与PWV加速进展相关。
高血压、高心率和高血清肌酐的存在是治疗的高血压患者主动脉僵硬度加速进展的主要决定因素。这是第一项评估长期动脉老化决定因素的纵向研究。
