Departments of Family and Preventive Medicine, University of California San Diego, La Jolla, Calif 92037, USA.
Hypertension. 2010 Apr;55(4):990-7. doi: 10.1161/HYPERTENSIONAHA.109.147520. Epub 2010 Feb 22.
The aim of this study was to determine the associations between the presence and extent of calcified atherosclerosis in multiple vascular beds and systolic blood pressure, diastolic blood pressure, pulse pressure, mean arterial pressure, isolated systolic hypertension, and hypertension. A total of 9510 patients (42.5% women) underwent electron beam computed tomography scanning as part of a routine health maintenance screening. At the same visit, blood pressure was measured with the participant in the seated position using a mercury sphygmomanometer. Mean age was 58+/-11.4 years, and body mass index was 27.1+/-4.5. The prevalences of any calcification in the carotids, coronaries, subclavians, thoracic aorta, abdominal aorta, and iliacs were 31.9%, 57.2%, 31.7%, 37.0%, 54.3%, and 48.8%, respectively. In separate multivariable logistic models containing traditional cardiovascular disease risk factors, pulse pressure and systolic blood pressure were significantly associated with the presence of calcification in all of the vascular beds except the iliacs and subclavians, respectively, with pulse pressure having stronger magnitudes of the associations for most of the vascular beds. Age-stratified analyses indicated that these associations were stronger in those >60 years of age compared with subjects <60 years of age, and sex-stratified analyses demonstrated that men had a greater association compared with women. Also, the magnitudes of the associations for isolated systolic hypertension were, in general, larger than those for hypertension. Pulse pressure and isolated systolic hypertension are robust and important correlates for calcified atherosclerosis in different vascular beds. Isolated systolic hypertension may be clinically relevant in diagnosing or preventing calcified atherosclerosis.
本研究旨在确定多个血管床中钙化性动脉粥样硬化的存在和程度与收缩压、舒张压、脉压、平均动脉压、孤立性收缩期高血压和高血压之间的关联。共有 9510 名患者（42.5%为女性）接受了电子束计算机断层扫描检查，作为常规健康维护筛查的一部分。在同一就诊时，使用汞柱血压计让参与者坐在座位上测量血压。平均年龄为 58+/-11.4 岁，体重指数为 27.1+/-4.5。颈动脉、冠状动脉、锁骨下动脉、胸主动脉、腹主动脉和髂动脉存在任何钙化的患病率分别为 31.9%、57.2%、31.7%、37.0%、54.3%和 48.8%。在分别包含传统心血管疾病危险因素的多变量逻辑模型中，脉压和收缩压与除髂动脉和锁骨下动脉外所有血管床的钙化存在显著相关，其中脉压与大多数血管床的关联程度更强。分层分析表明，这些关联在>60 岁的人群中比<60 岁的人群更强，性别分层分析表明，男性与女性相比，关联更大。此外，孤立性收缩期高血压的关联幅度通常大于高血压。脉压和孤立性收缩期高血压是不同血管床钙化性动脉粥样硬化的有力且重要的相关因素。孤立性收缩期高血压在诊断或预防钙化性动脉粥样硬化方面可能具有临床意义。
