Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Hypertens. 2011 Jul;24(7):809-15. doi: 10.1038/ajh.2011.57. Epub 2011 Apr 14.
Accelerated central arterial stiffening as represented by progression of aortic pulse-wave velocity (PWV) may be influenced by cardiovascular disease (CVD) risk factors. Little is known about the relationships between CVD risk factors and PWV progression among women transitioning through the menopause, or whether these relationships vary by ethnicity.
We conducted a subgroup analysis of 303 African-American and Caucasian participants in the Study of Women's Health Across the Nation (SWAN) Heart Study which received PWV scans at baseline examination and at a follow-up examination at an average of 2.3 years later. CVD risk factors were also assessed at baseline.
Systolic blood pressure (SBP) and waist circumference were the strongest predictors of PWV progression, after adjustment for age, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, diastolic blood pressure (DBP), glucose, and triglyceride levels. The magnitude of the influence of SBP, DBP, LDL-C, and glucose on PWV progression varied by ethnicity (difference in slopes: P = 0.02 for SBP, P = 0.0009 for DBP, P = 0.005 for LDL-C, and P = 0.02 for glucose). The positive relationship between SBP and PWV progression was significant among women of both ethnicities. LDL-C, DBP, and, to a lesser extent, glucose levels were positively associated with PWV progression only among African Americans.
Blood pressure, LDL-C, glucose, and excess body size may be important targets for improving vascular health and preventing clinical outcomes related to arterial stiffening, particularly among African-American women.
以主动脉脉搏波速度(PWV)进展为代表的动脉僵硬度加速可能受心血管疾病(CVD)危险因素的影响。绝经后女性的 CVD 危险因素与 PWV 进展之间的关系以及这些关系是否因种族而异,知之甚少。
我们对参加全国妇女健康研究(SWAN)心脏研究的 303 名非裔美国人和白种人参与者进行了亚组分析,这些参与者在基线检查时和平均 2.3 年后的随访检查时接受了 PWV 扫描。CVD 危险因素也在基线时进行了评估。
在调整年龄、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇、舒张压(DBP)、血糖和甘油三酯水平后,收缩压(SBP)和腰围是 PWV 进展的最强预测因素。SBP、DBP、LDL-C 和血糖对 PWV 进展的影响程度因种族而异(斜率差异:SBP 为 P = 0.02,DBP 为 P = 0.0009,LDL-C 为 P = 0.005,血糖为 P = 0.02)。SBP 与 PWV 进展之间的正相关在两种族的女性中均具有统计学意义。LDL-C、DBP 以及在较小程度上的血糖水平与 PWV 进展呈正相关,仅在非裔美国人中如此。
血压、LDL-C、血糖和超重可能是改善血管健康和预防与动脉僵硬度相关的临床结局的重要目标,尤其是在非裔美国女性中。