Amar Jacques, Chamontin Bernard
Service de Médecine Interne et d'hypertension artérielle, CHU Toulouse , France.
Adv Cardiol. 2007;44:212-222. doi: 10.1159/000096732.
Blood pressure is a complex phenomenon that can be divided into two components: a steady and a pulsatile component. The pulsatile component is estimated by the pulse pressure which is mainly influenced by the large artery stiffness. The purpose of this review was to describe the relation between pulse pressure, cardiovascular risk factors and atherosclerosis. Epidemiological studies have shown positive correlations between pulse pressure and smoking or glucose metabolism impairment. More controversial data have been reported on the relation between blood lipids and large artery stiffness or pulse pressure. In cross-sectional studies, carotid, aortic and coronary plaques were associated with aortic stiffness, particularly echogenic or ulcerative plaques, and in a longitudinal study, the progression of atherosclerosis is accompanied by an increase in pulse pressure. From a pathophysiological point of view, the deleterious influence of most risk factors on endothelial function and the development of atheroma are likely to contribute to these relations. Furthermore, with respect to the connections observed between C-reactive protein, most cardiovascular risk factors, atherosclerotic diseases and pulse pressure, subclinical inflammation might also underlie these relations.
血压是一种复杂的现象，可分为两个组成部分：稳定成分和搏动成分。搏动成分通过脉压来估计，脉压主要受大动脉僵硬度的影响。本综述的目的是描述脉压、心血管危险因素与动脉粥样硬化之间的关系。流行病学研究表明，脉压与吸烟或糖代谢受损之间存在正相关。关于血脂与大动脉僵硬度或脉压之间的关系，报道的数据更具争议性。在横断面研究中，颈动脉、主动脉和冠状动脉斑块与主动脉僵硬度相关，特别是回声或溃疡性斑块，并且在一项纵向研究中，动脉粥样硬化的进展伴随着脉压的增加。从病理生理学角度来看，大多数危险因素对内皮功能和动脉粥样硬化发展的有害影响可能导致了这些关系。此外，关于在C反应蛋白、大多数心血管危险因素、动脉粥样硬化疾病和脉压之间观察到的联系，亚临床炎症也可能是这些关系的潜在原因。
