Li Shengxu, Chen Wei, Srinivasan Sathanur R, Berenson Gerald S
Tulane Center for Cardiovascular Health, 1440 Canal Street, Suite 1829, New Orleans, LA 70112, USA.
Hypertension. 2004 Mar;43(3):541-6. doi: 10.1161/01.HYP.0000115922.98155.23. Epub 2004 Jan 26.
Increased arterial stiffness is an independent predictor of cardiovascular disease and mortality in middle-aged and older adults. However, limited data are available regarding the relationship of arterial stiffness in young adults with risk factors measured in childhood, adulthood, or as a cumulative burden from childhood to adulthood. This aspect was examined in a sample of 835 black and white young adults (72% whites, 44% men) aged 24 to 44 years who had at least 4 measurements of traditional risk factors over an average follow-up period of 26.5 years since childhood. Brachial-ankle pulse wave velocity (baPWV) measured by a simple automatic oscillometric technique was used as an index of arterial stiffness. The cumulative burden of risk factors since childhood was measured as area under the curve divided by follow-up years. In young adults, the baPWV was higher in males versus females (P<0.001) and blacks versus whites (P<0.001). In multiple regression analyses, independent predictors of baPWV in young adults were systolic blood pressure in childhood; systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and smoking in adulthood; and cumulative burden of systolic blood pressure and triglycerides and duration of smoking years from childhood. Thus, systolic blood pressure beginning in childhood is a consistent predictor of arterial stiffness in free-living, asymptomatic young adults. These findings underscore the importance of childhood blood pressure in the evolution of arterial stiffness and the need for beginning preventive cardiology early in life.
动脉僵硬度增加是中老年人心血管疾病和死亡率的独立预测因素。然而，关于年轻成年人动脉僵硬度与儿童期、成年期测量的危险因素或从儿童期到成年期的累积负担之间的关系，可用数据有限。在835名年龄在24至44岁的黑人和白人年轻成年人（72%为白人，44%为男性）样本中对此进行了研究，这些人自儿童期起平均随访26.5年，至少进行了4次传统危险因素测量。通过简单的自动示波技术测量的肱踝脉搏波速度（baPWV）被用作动脉僵硬度指标。自儿童期起危险因素的累积负担以曲线下面积除以随访年数来衡量。在年轻成年人中，男性的baPWV高于女性（P<0.001），黑人高于白人（P<0.001）。在多元回归分析中，年轻成年人baPWV的独立预测因素包括儿童期收缩压；成年期收缩压、高密度脂蛋白胆固醇、甘油三酯和吸烟情况；以及儿童期收缩压和甘油三酯的累积负担以及吸烟年限。因此，儿童期开始的收缩压是自由生活、无症状年轻成年人动脉僵硬度的一致预测因素。这些发现强调了儿童期血压在动脉僵硬度演变中的重要性，以及在生命早期开展预防性心脏病学的必要性。
