Department of Geriatric Medicine, Ehime Graduate School of Medicine, Toon City, Japan.
Am J Hypertens. 2010 Aug;23(8):889-94. doi: 10.1038/ajh.2010.60. Epub 2010 Mar 25.
Recent studies have reported the association between advanced arterial stiffness and brain small vessel diseases (SVDs). Two possible hemodynamic mechanisms, increases in central blood pressure (BP) and pulsatile flow load to the brain, have been speculated to link arterial stiffness and SVD. The carotid flow augmentation index (AI) has been proposed as an index of pulsatile flow to the brain. We compared its association with brain SVD with that of central BP in a general population.
Subjects were 500 individuals free from symptomatic cardiovascular diseases with a mean age of 66.9 +/- 8.4 years. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness. Carotid flow AI was obtained by Doppler ultrasonography. The presence of silent cerebral lacunar infarcts (SCI) was determined as a manifestation of SVD by 3-tesla magnetic resonance imaging (MRI). Second peak radial systolic BP (SBP2) and pulse pressure (PP2) were used as estimates of central BP.
baPWV was significantly associated with radial BP2 (r = 0.55, P < 0.0001) but not with carotid flow AI (r = 0.03, P = 0.51). Radial BPs and baPWV, but not flow AI, were significantly higher in subjects with SCI. Radial SBP2 had higher odds ratio for the presence of SCI than brachial SBP, PP, and radial PP2. Logistic regression analysis showed that radial SBP2, but not flow AI, was independently related to the presence of SCI.
These findings indicate that the SBP2, an estimate of central SBP, is significantly associated with the presence of SVD in an apparently healthy general population.
最近的研究报告了动脉僵硬与脑小血管疾病（SVD）之间的关联。两种可能的血流动力学机制，即中心血压（BP）升高和脉动血流负荷增加到大脑，被推测与动脉僵硬和 SVD 有关。颈动脉血流增强指数（AI）已被提议作为脉动血流到大脑的指标。我们在一般人群中比较了它与脑 SVD 的关联与中心 BP 的关联。
研究对象是 500 名无症状心血管疾病的个体，平均年龄为 66.9 +/- 8.4 岁。肱踝脉搏波速度（baPWV）作为动脉僵硬的指标进行测量。通过多普勒超声获得颈动脉血流 AI。通过 3 特斯拉磁共振成像（MRI）确定无症状性脑腔隙性梗死（SCI）的存在作为 SVD 的表现。第二峰值桡动脉收缩压（SBP2）和脉压（PP2）被用作中心 BP 的估计值。
baPWV 与桡动脉 SBP2 显著相关（r = 0.55，P < 0.0001），但与颈动脉血流 AI 无关（r = 0.03，P = 0.51）。SCI 患者的桡动脉 BP 和 baPWV 明显较高。与肱动脉 SBP、PP 和桡动脉 PP2 相比，桡动脉 SBP2 对 SCI 的存在具有更高的优势比。逻辑回归分析表明，桡动脉 SBP2 与 SCI 的存在独立相关，而不是血流 AI。
这些发现表明，SBP2，即中心 SBP 的估计值，与健康人群中 SVD 的存在显著相关。
