Chen Huimin, Hua Qi, Hou Haixia
Department of Cardiology, Xuanwu Hospital, Capital Medical University, China.
Intern Med. 2011;50(22):2759-65. doi: 10.2169/internalmedicine.50.5832. Epub 2011 Nov 15.
Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortality in hypertensive patients, but the underlying mechanism remains unclear. However, an increased Ambulatory Arterial Stiffness Index (AASI), the surrogate maker of arterial stiffness, has been proven to be an independent predictor of cardiovascular disease. This pilot study evaluated the association between Hb and AASI in untreated essential hypertensive patients without anemia.
A total of 566 untreated essential hypertensive patients without anemia were divided into Normal-Hb and High-Hb groups according to their Hb levels. The AASI and its symmetric calculation (Sym_AASI) were derived from 24h-Ambulatory Blood Pressure Monitoring (24h-ABPM). A multivariable linear regression analysis was performed to determine the relationship between Hb and AASI, Sym_AASI.
High-Hb group (n=127) showed higher AASI and Sym_AASI (0.51±0.11 vs 0.43±0.12, p<0.001; 0.33±0.10 vs 0.27±0.08, p<0.001) compared to Normal-Hb group (n=439). Univariate correlation analysis showed that Hb levels were positively related to AASI and Sym_AASI values (r=0.459, p<0.001; r=0.353, p<0.001). After adjustment for age, sex, BMI, current smoker, eGFR, uric acid, total cholesterol, high-density lipoprotein, 24h-SBP, 24h-PP and dipper status, Hb persisted as a independent determinant of AASI and Sym_AASI (β=0.402, p<0.001 and β=0.298, p<0.001, respectively).
High hemoglobin seems be to associated with increased AASI in untreated essential hypertensive patients without anemia.
已知高血压患者血红蛋白（Hb）水平升高与心血管事件及死亡率增加相关，但其潜在机制仍不清楚。然而，动态动脉僵硬度指数（AASI）升高，作为动脉僵硬度的替代指标，已被证明是心血管疾病的独立预测因子。本前瞻性研究评估了未治疗的无贫血原发性高血压患者中Hb与AASI之间的关联。
总共566例未治疗的无贫血原发性高血压患者根据其Hb水平分为正常Hb组和高Hb组。AASI及其对称计算值（Sym_AASI）来自24小时动态血压监测（24h-ABPM）。进行多变量线性回归分析以确定Hb与AASI、Sym_AASI之间的关系。
与正常Hb组（n = 439）相比，高Hb组（n = 127）的AASI和Sym_AASI更高（0.51±0.11对0.43±0.12，p<0.001；0.33±0.10对0.27±0.08，p<0.001）。单变量相关性分析显示Hb水平与AASI和Sym_AASI值呈正相关（r = 0.459，p<0.001；r = 0.353，p<0.001）。在调整年龄、性别、体重指数、当前吸烟者、估算肾小球滤过率、尿酸、总胆固醇、高密度脂蛋白、24小时收缩压、24小时脉压和勺型状态后，Hb仍然是AASI和Sym_AASI的独立决定因素（β = 0.402，p<0.001和β = 0.298，p<0.001）。
在未治疗的无贫血原发性高血压患者中，高血红蛋白似乎与AASI升高有关。
