Boĭtsov S A, Rogoza A N, Kanishcheva E M, Luk'ianov M M
Ter Arkh. 2011;83(9):5-9.
To ascertain whether high arterial rigidity is obligatory in arterial hypertension (AH) and the presence of AH is obligatory in patients with rigid arteries.
Volume sphygmography (VS) was made in 153 patients aged 60-86 years: 96 patients with untreated AH of degree 1-3 (40 males aged 71.0 +/- 7.6 years) and 57 normotensive subjects without cardiovascular symptoms (31 males aged 66.6 +/- 6.2 years). VS measured ankle-shoulder velocity of the pulse wave (PWVas) and cardiac-ankle vascular index (CAVI). PWVas > M+STD and CAVI > M+2STD (STD is deviation from mean value) were considered above normal for the age.
Hypertensive patients had significantly higher arterial rigidity than normotensives (PWVas 178 +/- 3.0 and 15.6 +/- 2.3 m/s, respectively, p = 0.00001); CAVI--9.7 +/- 2.1 and 8.6 +/- 1.1, respectively, p = 0.0003). Arterial rigidity in hypertensive patients occurred significantly more frequently than in normotensive subjects: by PWVas in 46 and 25% cases (p = 0.01), by CAVI--in 41 and 5% cases (p < 0.0001), respectively. It is essential that arterial rigidity was not increased in 54% hypertensive patients by PWVas and in 75% by CAVI.
PWVas and CAVI were higher in elderly hypertensives than in elderly normotensives but elevated arterial rigidity was not obligatory in hypertensives while 25% elderly normotensives had it. Thus, elevated arterial rigidity is an essential but not obligatory mechanism of AH development in the elderly.
确定在动脉高血压(AH)中高动脉僵硬度是否必然存在,以及在动脉僵硬的患者中AH是否必然存在。
对153例年龄在60 - 86岁的患者进行了容积脉搏波描记法(VS)检查:96例未经治疗的1 - 3级AH患者(40例男性,年龄71.0±7.6岁)和57例无心血管症状的血压正常受试者(31例男性,年龄66.6±6.2岁)。VS测量了脉搏波的踝 - 肩速度(PWVas)和心 - 踝血管指数(CAVI)。PWVas > M + STD且CAVI > M + 2STD(STD为与平均值的偏差)被认为高于该年龄的正常范围。
高血压患者的动脉僵硬度显著高于血压正常者(PWVas分别为178±3.0和15.6±2.3 m/s,p = 0.00001);CAVI分别为9.7±2.1和8.6±1.1,p = 0.0003)。高血压患者中动脉僵硬度出现的频率显著高于血压正常受试者:按PWVas计算分别为46%和25%(p = 0.01),按CAVI计算分别为41%和5%(p < 0.0001)。重要的是,54%的高血压患者按PWVas计算动脉僵硬度未增加,75%按CAVI计算未增加。
老年高血压患者的PWVas和CAVI高于老年血压正常者,但高血压患者中动脉僵硬度升高并非必然,而25%的老年血压正常者存在动脉僵硬度升高。因此,动脉僵硬度升高是老年AH发生发展的一个重要但非必然机制。