Nijdam Marie-Elise, Plantinga Yvonne, Hulsen Hans T, Bos Willem J W, Grobbee Diederick E, van der Schouw Yvonne T, Bots Michiel L
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Am J Hypertens. 2008 Apr;21(4):388-92. doi: 10.1038/ajh.2007.89. Epub 2008 Mar 6.
Whether pulse pressure amplification (PPA) relates to established markers of cardiovascular risk is unknown. The purpose of this study was to investigate the relationship between PPA and cardiovascular risk factors and cardiovascular risk in a population-based sample of 40- to 80-year old men.
A cross-sectional, single-center study was performed in 400 men aged 40-80 years. PPA was calculated as a ratio (brachial pulse pressure/central pulse pressure). Detailed information on vascular risk factors was obtained. Aortic pulse wave velocity (PWV) and common carotid intima-media thickness (CIMT), as markers of vascular risk, were measured. We calculated the absolute 10-year risk of coronary heart disease using the Framingham risk score. Regression analysis was used to evaluate the relations under study.
In models adjusted for age, mean arterial pressure (MAP), heart rate, and height, significant inverse relations with PPA were found for waist-to-hip ratio, triglycerides, smoking, pack-years, and hypertension. Furthermore, an increased PPA was significantly inversely related to aortic PWV, common CIMT, and history of symptomatic vascular disease. Finally, the Framingham risk score decreased with increasing PPA.
Our study shows that a higher PPA reflects a lower vascular risk in men between 40 and 80 years of age, as shown by a better cardiovascular risk profile, a reduced PWV, common CIMT, and a lower Framingham risk of coronary heart disease.
脉压放大（PPA）是否与既定的心血管风险标志物相关尚不清楚。本研究的目的是在40至80岁男性的基于人群的样本中，研究PPA与心血管危险因素及心血管风险之间的关系。
对400名年龄在40至80岁的男性进行了一项横断面单中心研究。PPA计算为一个比值（肱动脉脉压/中心脉压）。获取了有关血管危险因素的详细信息。测量了作为血管风险标志物的主动脉脉搏波速度（PWV）和颈总动脉内膜中层厚度（CIMT）。我们使用弗雷明汉风险评分计算了冠心病的绝对10年风险。采用回归分析来评估所研究的关系。
在根据年龄、平均动脉压（MAP）、心率和身高进行调整的模型中，发现腰臀比、甘油三酯、吸烟、吸烟包年数和高血压与PPA呈显著负相关。此外，PPA升高与主动脉PWV、颈总动脉CIMT以及有症状血管疾病史显著负相关。最后，弗雷明汉风险评分随PPA升高而降低。
我们的研究表明，较高的PPA反映40至80岁男性较低的血管风险，表现为更好的心血管风险状况、降低的PWV、颈总动脉CIMT以及较低的弗雷明汉冠心病风险。
