Shiburi Cleopatra P, Staessen Jan A, Maseko Muzi, Wojciechowska Wiktoria, Thijs Lutgarde, Van Bortel Luc M, Woodiwiss Angela J, Norton Gavin R
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Am J Hypertens. 2006 Jan;19(1):40-6. doi: 10.1016/j.amjhyper.2005.06.018.
Measurements of blood pressure (BP) together with applanation tonometry at the radial and femoral arteries allow for reproducible assessments of various indexes of arterial stiffness, including peripheral (PP(p)) and central (PP(c)) pulse pressures, peripheral (AI(p)) and central (AI(c)) augmentation indexes, and aortic pulse wave velocity (PWV). In the absence of an outcome-driven and ethnicity-specific reference frame, we defined preliminary diagnostic thresholds for subjects of African descent living in Africa, using the distributional characteristics of these hemodynamic measurements.
We randomly recruited 347 subjects from a South African population of African origins. The PP(p) was the average difference between systolic and diastolic BP measured five times consecutively at one home visit. For measurement of PP(c), AI(p), AI(c), and PWV, we used a high-fidelity micromanometer interfaced with a laptop computer running the SphygmoCor software. For analyses we selected 185 subjects without hypertension, diabetes, and previous or concomitant cardiovascular disease.
Mean age (33.5 years) was similar in 77 men and 108 women. The PP(p), PP(c), AI(p), AI(c), and PWV significantly increased with age. The 95th prediction bands of this relation at age 30 years, approximated to 70 mm Hg for PP(p), 50 mm Hg for PP(c), 100% for AI(p), 40% for AI(c), and 8.0 m/sec for PWV. The aforementioned thresholds would need adjustment by approximately 2.5 mm Hg, 4.0 mm Hg, 10%, 6%, and 1.0 m/sec, respectively, for each decade that age differs from 30 years.
Pending validation in prospective outcome-based studies 70 mm Hg for PP(p), 50 mm Hg for PP(c), 100% for AI(p), 40% for AI(c), and 8.0 m/sec might be considered as preliminary thresholds to diagnose increased arterial stiffness in young adult subjects of African descent.
通过测量血压（BP）并结合桡动脉和股动脉的压平式眼压测量法，可以对动脉僵硬度的各种指标进行可重复评估，包括外周（PP(p)）和中心（PP(c)）脉压、外周（AI(p)）和中心（AI(c)）增强指数以及主动脉脉搏波速度（PWV）。在缺乏基于结果和特定种族的参考框架的情况下，我们利用这些血流动力学测量的分布特征，为生活在非洲的非洲裔受试者定义了初步诊断阈值。
我们从南非非洲裔人群中随机招募了347名受试者。PP(p)是在一次家庭访视中连续测量五次的收缩压和舒张压之间的平均差值。对于PP(c)、AI(p)、AI(c)和PWV的测量，我们使用了与运行SphygmoCor软件的笔记本电脑相连的高保真微压计。在分析中，我们选择了185名没有高血压、糖尿病以及既往或并发心血管疾病的受试者。
77名男性和108名女性的平均年龄（33.5岁）相似。PP(p)、PP(c)、AI(p)、AI(c)和PWV均随年龄显著增加。在30岁时，这种关系的第95百分位预测区间，PP(p)约为70 mmHg，PP(c)约为50 mmHg，AI(p)为100%，AI(c)为40%，PWV为8.0 m/sec。对于年龄与30岁相差每十年，上述阈值分别需要调整约2.5 mmHg、4.0 mmHg、10%、6%和1.0 m/sec。
在基于前瞻性结果的研究得到验证之前，对于非洲裔年轻成年受试者，PP(p)为70 mmHg、PP(c)为50 mmHg、AI(p)为100%、AI(c)为40%以及PWV为8.0 m/sec可被视为诊断动脉僵硬度增加的初步阈值。
