Tedesco M A, Natale F, Di Salvo G, Caputo S, Capasso M, Calabró R
Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Monaldi Hospital, Naples, Italy.
J Hum Hypertens. 2004 Jul;18(7):469-73. doi: 10.1038/sj.jhh.1001690.
Hypertension (HT) is frequently associated with diabetes mellitus (DM) and its prevalence doubles in diabetics compared to the general population. This high prevalence is associated with increased stiffness of large arteries, which often precedes macrovascular events. The aim of our study was to evaluate the influence of HT and type II DM on aortic stiffness in patients with one disease or the other compared to those with both HT and type II DM. We studied 220 patients, 50 with type II DM (Group A), 50 with HT (Group B), 85 with both diseases (Group C), and 35 healthy subjects (HS). Regional arterial stiffness was assessed by automatic measurement of the carotid-femoral pulse wave velocity (PWV). For each patient, we evaluated: age, sex, body mass index, smoking habit, heart rate, SBP/DBP, pulse pressure (PP), mean BP, fasting glucose, lipid profile, uric acid, and fibrinogen. Group C had significantly more women and non smokers and the highest PP (61+/-14 mmHg). Of biochemical parameters, only fibrinogen was higher in Group A and in Group C (P<0.01 and P<0.001, respectively). Group C had a significantly higher PWV than the other four groups (P<0.0001). Stepwise forward regression analysis showed that fasting glucose was the first independent determinant of PWV (P<0.0001). In conclusion, this study shows that patients with DM and HT have higher arterial stiffness compared to HS and those with one disease or the other. Fasting glucose is the major independent determinant of PWV, which may be used as a relevant tool to assess the influence of cardiovascular risk factors on arterial stiffness in high-risk patients.
高血压（HT）常与糖尿病（DM）相关，与普通人群相比，糖尿病患者中高血压的患病率翻倍。这种高患病率与大动脉僵硬度增加有关，而大动脉僵硬度增加往往先于大血管事件发生。我们研究的目的是评估与患有高血压和2型糖尿病两者的患者相比，单纯患有高血压或2型糖尿病其中一种疾病的患者中，高血压和2型糖尿病对主动脉僵硬度的影响。我们研究了220名患者，50名2型糖尿病患者（A组），50名高血压患者（B组），85名同时患有这两种疾病的患者（C组），以及35名健康受试者（HS）。通过自动测量颈股脉搏波速度（PWV）来评估局部动脉僵硬度。对于每位患者，我们评估了：年龄、性别、体重指数、吸烟习惯、心率、收缩压/舒张压、脉压（PP）、平均血压、空腹血糖、血脂谱、尿酸和纤维蛋白原。C组女性和非吸烟者明显更多，且脉压最高（61±14 mmHg）。在生化参数方面，仅A组和C组的纤维蛋白原较高（分别为P<0.01和P<0.001）。C组的脉搏波速度显著高于其他四组（P<0.0001）。逐步向前回归分析表明，空腹血糖是脉搏波速度的首要独立决定因素（P<0.0001）。总之，本研究表明，与健康受试者以及患有其中一种疾病的患者相比，患有糖尿病和高血压的患者动脉僵硬度更高。空腹血糖是脉搏波速度的主要独立决定因素，可作为评估心血管危险因素对高危患者动脉僵硬度影响的相关工具。
