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老年原发性高血压患者总抗氧化状态与动脉粥样硬化的关系

[Association between total antioxidant status and atherosclerosis in elderly patients with essential hypertension].

作者信息

Cao Jie, Wang Hai-ya

机构信息

Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China.

Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China. Email:

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2013 Oct;41(10):857-61.

Abstract

OBJECTIVE

To investigate the association between plasma total antioxidant status (TAS) and association with brachial-ankle pulsewave velocity (baPWV) in the elderly patients with essential hypertension(EH).

METHODS

A total of 133 consecutive EH patients older than 60 years were enrolled and another 92 elderly non-EH healthy subjects served as control. According to blood pressure level, EH patients were further classified into three subgroups. The concentration of plasma total antioxidant status was measured by using chemical luminescence method. High-sensitive CRP, urine microalbumin, uric acid, blood lipids and blood glucose levels were also measured. Carotid intima-media thickness was determined by color Doppler ultrasonography and the degree of arteriosclerosis was investigated with baPWV and ankle-brachial index (ABI).

RESULTS

(1) Plasma levels of TAS in EH patients were significant lower than in control group [(1.123 ± 0.126)mmol/L vs. (1.258 ± 0.125) mmol/L, P < 0.05], and were similar among hypertension subgroups (P > 0.05).(2) Stepwise multiple regression analysis showed that age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high-sensitive CRP, UA were dependent variables of TAS. Multivariate regression analysis showed that high-sensitivity CRP, UA were independent factors affecting TAS (β = -0.03, standardized β = -0.01, P < 0.05). (3) Compared with the control group, baPWV was significantly higher in elderly EH patients left baPWV (1914 ± 341) cm/s vs. (1817 ± 322) cm/s, right baPWV (1899 ± 330) cm/s vs. (1772 ± 345) cm/s(P < 0.05)and baPWV tended to increase with the level of blood pressure of EH group (P < 0.05) . (4) After adjusting for age, CRP, UA, partial correlation analysis showed that plasma TAS was negatively correlated with baPWV (r = -0.459, P < 0.05).

CONCLUSIONS

Our results indicate that TAS and arterial elasticity are decreased while arterial stiffness is increased in elderly hypertensive patients. The decline in antioxidant capacity may be responsible for vascular damage and arterial elasticity decrease in elderly EH patients.

摘要

目的

探讨老年原发性高血压(EH)患者血浆总抗氧化状态(TAS)与臂踝脉搏波速度(baPWV)之间的关系。

方法

连续纳入133例年龄大于60岁的EH患者,另选92例老年非EH健康受试者作为对照。根据血压水平,将EH患者进一步分为三个亚组。采用化学发光法测定血浆总抗氧化状态浓度。同时检测高敏CRP、尿微量白蛋白、尿酸、血脂和血糖水平。采用彩色多普勒超声测定颈动脉内膜中层厚度,并用baPWV和踝臂指数(ABI)评估动脉硬化程度。

结果

(1)EH患者血浆TAS水平显著低于对照组[(1.123±0.126)mmol/L vs.(1.258±0.125)mmol/L,P<0.05],且在高血压亚组之间相似(P>0.05)。(2)逐步多元回归分析显示,年龄、性别、体重指数、收缩压、舒张压、高敏CRP、尿酸是TAS的因变量。多因素回归分析显示,高敏CRP、尿酸是影响TAS的独立因素(β=-0.03,标准化β=-0.01,P<0.05)。(3)与对照组相比,老年EH患者的baPWV显著升高[左baPWV(1914±341)cm/s vs.(1817±322)cm/s,右baPWV(1899±330)cm/s vs.(1772±345)cm/s,P<0.05],且baPWV随EH组血压水平升高而升高(P<0.05)。(4)校正年龄、CRP、尿酸后,偏相关分析显示血浆TAS与baPWV呈负相关(r=-0.459,P<0.05)。

结论

我们的结果表明,老年高血压患者的TAS和动脉弹性降低,而动脉僵硬度增加。抗氧化能力下降可能是老年EH患者血管损伤和动脉弹性降低的原因。

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