Reeve Jake C, Abhayaratna Walter P, Davies Justin E, Sharman James E
Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia.
Am J Hypertens. 2014 Mar;27(3):392-400. doi: 10.1093/ajh/hpt222. Epub 2013 Dec 4.
Mechanisms underlying the inverse relationship between height and cardiovascular mortality are unknown but could relate to central hemodynamics. We sought to determine the relation of height to central and peripheral hemodynamics, as well as clinical characteristics.
The study population was comprised of 1,152 randomly selected community-dwelling adults (aged 67.7 ± 12.3 years; 48% men). Brachial blood pressure (BP) was recorded by sphygmomanometry; central BP and aortic pulse wave velocity were estimated by applanation tonometry. Stepwise multiple regression analysis was used to determine associations between height and central and peripheral hemodynamics.
Height was not significantly associated with aortic pulse wave velocity in men or women. The relationship with height and brachial systolic BP was borderline in women (β = -0.115; P = 0.051) but not significant in men (β = -0.096; P = 0.09). Conversely, central systolic BP, estimated by transfer function (β = -0.139 for men [βM]; β = -0.172 for women [βW]) or radial second systolic peak (β M = -0.239; β W = -0.281), augmentation index at 75 bpm (β M = -0.189; β W = -0.224), and aortic pulse wave timing (β M = 0.224; β W = 0.262) were independently associated with height in both sexes (P < 0.003 for all). Both men and women of greater than median height were less likely to have coronary artery disease (P < 0.05), to have systemic hypertension (P < 0.01), or to be taking vasoactive medication (P < 0.001) compared with participants of less than median height.
Even after correcting for conventional cardiovascular risk factors, taller individuals have more favorable central hemodynamics and reduced evidence of coronary artery disease compared with shorter individuals. These findings may help explain the decreased cardiovascular risk associated with being taller and also have important clinical consequences regarding therapy.
身高与心血管疾病死亡率之间呈负相关的潜在机制尚不清楚，但可能与中心血流动力学有关。我们试图确定身高与中心和外周血流动力学以及临床特征之间的关系。
研究人群包括1152名随机选择的社区成年居民（年龄67.7±12.3岁；48%为男性）。通过血压计记录肱动脉血压；采用压平式眼压计估计中心血压和主动脉脉搏波速度。采用逐步多元回归分析确定身高与中心和外周血流动力学之间的关联。
男性和女性的身高与主动脉脉搏波速度均无显著相关性。女性身高与肱动脉收缩压之间的关系接近临界值（β=-0.115；P=0.051），但男性不显著（β=-0.096；P=0.09）。相反，通过传递函数估计的中心收缩压（男性[βM]=-0.139；女性[βW]=-0.172）或桡动脉第二收缩峰（βM=-0.239；βW=-0.281）、75次/分时的增强指数（βM=-0.189；βW=-0.224）以及主动脉脉搏波时间（βM=0.224；βW=0.262）在两性中均与身高独立相关（所有P<0.003）。与身高低于中位数的参与者相比，身高高于中位数的男性和女性患冠状动脉疾病的可能性更小（P<0.05），患系统性高血压的可能性更小（P<0.01），服用血管活性药物的可能性更小（P<0.001）。
即使校正了传统心血管危险因素，与较矮个体相比，较高个体具有更有利的中心血流动力学，且冠状动脉疾病证据减少。这些发现可能有助于解释身高较高与心血管风险降低之间的关系，也对治疗具有重要的临床意义。
