Doba Nobutaka, Tokuda Yasuharu, Tomiyama Hirofumi, Goldstein Nathan E, Kushiro Toshio, Hinohara Shigeaki
Division of Research and Education, Life Planning Center Foundation, Japan.
Intern Med. 2013;52(1):21-7. doi: 10.2169/internalmedicine.52.8671. Epub 2013 Jan 1.
Brachial-ankle pulse wave velocity (baPWV) is a measure of arterial stiffness. However, precisely how aging, hypertension and other factors influence this in progressively stiffening large arteries, especially in older adults, remains uncertain. We examined changes in arterial stiffness in a population of active older Japanese adults using a five-year follow-up cohort study.
Comprehensive geriatric assessments were performed in socially active adults over the age of 70 years at The Life Planning Center Clinic in Tokyo. Clinically acceptable baPWV measurements at baseline and at the end of the study were obtained in 257 individuals (115 men, baseline mean age of 78±4 years; 142 women, baseline mean age of 77±4 years) classified into four groups based on the use of antihypertensive interventions at the end of the study: Group 1 (112 normotensives), Group 2 (49 hypertensives without medication use), Group 3 (39 hypertensives with medication use initiated during the follow-up period) and Group 4 (57 hypertensives receiving medications throughout the follow-up period).
During the follow-up period, Group 1 exhibited no changes in blood pressure with increases in baPWV. Group 2 exhibited increases in blood pressure and baPWV. Both Groups 3 and 4 exhibited decreases in blood pressure without any changes in baPWV. Other factors such as age, gender and the hemoglobin level could also have influenced baPWV.
Arterial stiffness increases with aging; however, antihypertensive medications were found to provide protective effects against the development of arterial stiffness during a five-year follow-up period. Other factors that modify baPWV were also identified.
肱踝脉搏波速度(baPWV)是动脉僵硬度的一种测量指标。然而,衰老、高血压和其他因素究竟如何在逐渐硬化的大动脉中,尤其是在老年人中影响这一指标,仍不明确。我们通过一项为期五年的随访队列研究,调查了活跃的日本老年人群体中动脉僵硬度的变化情况。
在东京生活规划中心诊所,对70岁以上的社会活跃成年人进行了全面的老年医学评估。在257名个体(115名男性,基线平均年龄为78±4岁;142名女性,基线平均年龄为77±4岁)中获得了基线和研究结束时临床上可接受的baPWV测量值,这些个体根据研究结束时使用降压干预措施被分为四组:第1组(112名血压正常者),第2组(49名未使用药物的高血压患者),第3组(39名在随访期间开始使用药物的高血压患者)和第4组(57名在整个随访期间接受药物治疗的高血压患者)。
在随访期间,第1组血压无变化,但baPWV升高。第2组血压和baPWV均升高。第3组和第4组血压均下降,但baPWV无变化。年龄、性别和血红蛋白水平等其他因素也可能影响baPWV。
动脉僵硬度随年龄增长而增加;然而,在为期五年的随访期间,发现降压药物对动脉僵硬度的发展具有保护作用。还确定了其他影响baPWV的因素。