Mao Yong, Yu Jin-ming, Hu Da-yi, Jiang Qing-wu, Zhang Fen, Zhan Yi-qiang, Dong Ying, Kong Qun-yu
Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2011 Nov 15;91(42):2985-9.
To evaluate the relevance of cardiovascular disease (CVD) risk and abnormal ankle brachial index (ABI) in high-risk and very high-risk hypertensive patients and explore the strategies of prevention and treatment for peripheral arterial disease according to the CVD risk.
Between December 2008 and May 2009, the cross-sectional study investigated the prevalence of abnormal ABI (ABI < 0.90) in 2674 community-dwelling, hypertensive patients, aged ≥ 40 years old, without coronary heart disease, stroke/transient ischemic attack or known arteriosclerosis, from 18 centers in China. The relevant data were acquired through history, physical examination, laboratory examinations and other diagnostic tests.
The number of subjects available for the full-analysis set was 2615. There was a rising prevalence of abnormal ABI with the advancing age in high-risk hypertensive patients and very high-risk ones (P < 0.001). Compared with the high-risk group, the 60 years (1.3% vs 5.1%) and 70 years (4.1% vs 10.5%) age sub-groups of the very high-risk group had a significantly higher prevalence of abnormal ABI (P < 0.05). After adjusting for such factors as investigational center, target organ damage, CVD risk and demographics, an unconditional Logistic regression model revealed that CVD risk was positively correlated with abnormal ABI (odds ratio 1.874, 95% confidence interval 1.153 - 3.045, P = 0.0112). A very high-risk hypertensive patient was 1.874 times more likely than a high-risk one to have an abnormal ABI.
A high-risk hypertensive patient with a higher CVD risk is more prone to have an abnormal ABI. Among the high-risk hypertensive patients in the 60 years and 70 years age sub-groups, such a positive correlation is especially pronounced.
评估高危和极高危高血压患者心血管疾病(CVD)风险与踝臂指数(ABI)异常之间的相关性,并根据CVD风险探索外周动脉疾病的防治策略。
2008年12月至2009年5月,这项横断面研究调查了来自中国18个中心的2674名年龄≥40岁、无冠心病、中风/短暂性脑缺血发作或已知动脉硬化的社区高血压患者中ABI异常(ABI<0.90)的患病率。通过病史、体格检查、实验室检查及其他诊断性检查获取相关数据。
可用于完整分析集的受试者数量为2615名。高危和极高危高血压患者中,ABI异常的患病率随年龄增长而上升(P<0.001)。与高危组相比,极高危组60岁(1.3%对5.1%)和70岁(4.1%对10.5%)年龄亚组的ABI异常患病率显著更高(P<0.05)。在对研究中心、靶器官损害、CVD风险和人口统计学等因素进行校正后,无条件Logistic回归模型显示CVD风险与ABI异常呈正相关(比值比1.874,95%置信区间1.153 - 3.045,P = 0.0112)。极高危高血压患者ABI异常的可能性是高危患者的1.874倍。
CVD风险较高的高危高血压患者更容易出现ABI异常。在60岁和70岁年龄亚组的高危高血压患者中,这种正相关尤为明显。