Hospital de Sagunto, Agencia Valenciana de Salud, Sagunto, Valencia, España.
Med Clin (Barc). 2010 Apr 24;134(12):528-33. doi: 10.1016/j.medcli.2009.09.042.
The purpose of the present study was to assess the relationship of arterial stiffness with other markers of target organ damage, and the clinical factors related to it.
Cross-sectional study that included 208 (115 men) never treated hypertensive, non-diabetic patients (mean age, 49+/-12 years). In addition to a full clinical study, 24h ambulatory blood pressure (BP), and determination of left ventricular hypertrophy (LVH) and microalbuminuria were performed. Clinical arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWV) obtained with applanation tonometry (SphygmoCor-System).
PWV was 8.3 (7.3-9.9)m/s (median, interquartile range). Stepwise regression analysis revealed that age (beta=0.086, p<0.001), 24-h pulse pressure (beta=0.058, p<0.001), and low-density lipoprotein (LDL) cholesterol (beta=0.009, p<0.013) were independent determinants of PWV. PWV>12m/s (indicating target organ lesion) was present in only 16 (7.7%) patients, less frequent than LVH (28% of the patients) and microalbuminuria (16%). However, of the 16 patients with elevated PWV, 10 (62%) had neither LVH or microalbuminuria. In a logistic multivariate regression analysis the factors related to elevated PWV were age > or =45 in man and > or =55 in women (OR: 23.8, 95% CI: 2.7-195.5; p=0.004), LDL cholesterol > or =160mg/dl (OR: 10.6, 95% CI: 2.6-42.7; p=0.001) and increased 24-h pulse pressure > or =55mmHg (OR: 3.9, 95% CI: 1.2-12.9; p=0.03).
In untreated middle age hypertensives arterial stiffness assessed by PWV is less frequent than LVH or microalbuminuria. PWV is mainly related to age, LDL cholesterol, and pulse pressure values.
本研究旨在评估动脉僵硬度与其他靶器官损害标志物之间的关系，以及与之相关的临床因素。
这是一项横断面研究，纳入了 208 例（男 115 例）未经治疗的高血压、非糖尿病患者（平均年龄 49+/-12 岁）。除了全面的临床研究外，还进行了 24 小时动态血压监测和左心室肥厚（LVH）及微量白蛋白尿的测定。应用平板压力传导法（SphygmoCor 系统）测量颈股脉搏波速度（PWV）以评估临床动脉僵硬度。
PWV 为 8.3（7.3-9.9）m/s（中位数，四分位间距）。逐步回归分析显示，年龄（β=0.086，p<0.001）、24 小时脉压（β=0.058，p<0.001）和低密度脂蛋白胆固醇（β=0.009，p<0.013）是 PWV 的独立决定因素。仅有 16 例（7.7%）患者的 PWV>12m/s（提示靶器官损伤），低于 LVH（28%）和微量白蛋白尿（16%）的发生率。然而，在 16 例 PWV 升高的患者中，有 10 例（62%）既无 LVH 也无微量白蛋白尿。在多变量逻辑回归分析中，与升高的 PWV 相关的因素包括男性年龄≥45 岁和女性年龄≥55 岁（OR：23.8，95%CI：2.7-195.5；p=0.004）、低密度脂蛋白胆固醇≥160mg/dl（OR：10.6，95%CI：2.6-42.7；p=0.001）和 24 小时脉压升高≥55mmHg（OR：3.9，95%CI：1.2-12.9；p=0.03）。
在未经治疗的中年高血压患者中，通过 PWV 评估的动脉僵硬度的发生率低于 LVH 或微量白蛋白尿。PWV 主要与年龄、低密度脂蛋白胆固醇和脉压值相关。
