Cardiology Division, Denver Health Medical Center, Denver, USA.
BMC Cardiovasc Disord. 2011 Apr 11;11:15. doi: 10.1186/1471-2261-11-15.
Preventive cardiology has expanded beyond coronary heart disease towards prevention of a broader spectrum of cardiovascular diseases. Ethnic minorities are at proportionately greater risk for developing extracoronary vascular disease including heart failure and cerebrovascular disease.
We performed a cross sectional study of Latino and White hypertension patients in a safety-net healthcare system. Framingham risk factors, markers of inflammation (hsCRP, LPpLA2), arterial stiffness (Pulse wave velocity, augmentation index, and central aortic pressure), and endothelial function (brachial artery flow-mediated dilatation) were measured. Univariate and multivariable associations between these parameters and an index of extracoronary atherosclerosis (carotid intima media thickness) was performed.
Among 177 subjects, mean age was 62 years, 67% were female, and 67% were Latino. In univariate analysis, markers associated with carotid intima media thickness (IMT) at p<0.25 included pulse wave velocity (PWV), augmentation index (AIx), central aortic pressure (cAP), and LpPLA2 activity rank. However, AIx, cAP, and LpPLA2 activity were not significantly associated with carotid IMT after adjusting for Framingham risk factors (all p>.10). Only PWV retained a significant association with carotid IMT independent of the Framingham general risk profile parameters (p=.016). No statistically significant interactions between Framingham and other independent variables with ethnicity (all p>.05) were observed.
In this safety net cohort, PWV is a potentially useful adjunctive atherosclerotic risk marker independent of traditional risk factors and irrespective of ethnicity.
预防心脏病学已从冠心病防治扩展到更广泛的心血管疾病防治。少数民族患冠状动脉外血管疾病（包括心力衰竭和脑血管疾病）的风险比例更高。
我们在一个医疗保障系统中对拉丁裔和白人高血压患者进行了一项横断面研究。测定了弗明汉危险因素、炎症标志物（hsCRP、LPpLA2）、动脉僵硬度（脉搏波速度、增强指数和中心主动脉压）和内皮功能（肱动脉血流介导的舒张功能）。对这些参数与冠状动脉外动脉粥样硬化指数（颈动脉内膜中层厚度）之间的关系进行了单变量和多变量分析。
在 177 名受试者中，平均年龄为 62 岁，67%为女性，67%为拉丁裔。在单变量分析中，与颈动脉内膜中层厚度（IMT）相关的标志物（p<0.25）包括脉搏波速度（PWV）、增强指数（AIx）、中心主动脉压（cAP）和 LpPLA2 活性。然而，在调整了弗明汉危险因素后，AIx、cAP 和 LpPLA2 活性与颈动脉 IMT 无显著相关性（均 p>.10）。只有 PWV 在独立于弗明汉一般风险特征参数的情况下与颈动脉 IMT 仍存在显著相关性（p=.016）。未观察到弗明汉和其他独立变量与种族之间存在统计学显著的交互作用（均 p>.05）。
在这个医疗保障人群中，PWV 是一种潜在有用的动脉粥样硬化附加风险标志物，独立于传统危险因素，与种族无关。
