From the Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison (R.S., M.C.T., A.D.G., C.E.K., J.H.S.); Department of Epidemiology, University of Washington School of Public Health, Seattle (J.K.); and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (L.A.C., K.L.).
Arterioscler Thromb Vasc Biol. 2015 Feb;35(2):478-84. doi: 10.1161/ATVBAHA.114.304870. Epub 2014 Dec 4.
To identify sex differences in predictors of longitudinal changes in carotid arterial stiffness in a multiethnic cohort.
Carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM) were measured in 2650 Multi-Ethnic Study of Atherosclerosis participants (45-84 years old and free of cardiovascular disease) at baseline and after a mean of 9.4 years. Predictors of changes in DC and YEM for each sex were evaluated using multivariable linear regression models. The 1236 men (46.6%) were 60.0 (SD, 9.3) years: 40% were white, 22% black, 16% Chinese, and 22% Hispanic. The 1414 (53.4%) women were 59.8 (9.4) years old with a similar race distribution. Despite similar rates of change in DC and YEM, predictors of changes in distensibility markers differed by sex. In men, Chinese (P=0.002) and black (P=0.003) race/ethnicity, systolic blood pressure (P=0.012), and diabetes mellitus (P=0.05) were associated with more rapidly decreasing DC (accelerated stiffening). Starting antihypertensive medication was associated with improved DC (P=0.03); stopping antihypertensives was associated with more rapid stiffening (increased YEM, P=0.05). In women, higher education was associated with slower stiffening (DC, P=0.041; YEM, P<0.001) as was use of lipid-lowering medication (P=0.03), whereas baseline use of antihypertensive medications (YEM, P=0.01) and systolic blood pressure (DC, P=0.02; P=0.04) predicted increasing stiffening in women.
Longitudinal changes in carotid artery stiffness are associated with systolic blood pressure and antihypertensive therapy in both sexes; however, race/ethnicity (in men) and level of education (in women) may have different contributions between the sexes.
在一个多民族队列中，确定颈动脉动脉僵硬的纵向变化的预测因素中的性别差异。
在基线和平均 9.4 年后，在 2650 名多民族动脉粥样硬化研究参与者（年龄 45-84 岁且无心血管疾病）中测量了颈动脉可扩张系数（DC）和杨氏弹性模量（YEM）。使用多变量线性回归模型评估了每个性别的 DC 和 YEM 变化的预测因素。1236 名男性（46.6%）为 60.0（标准差，9.3）岁：40%为白人，22%为黑人，16%为中国人，22%为西班牙裔。1414 名（53.4%）女性为 59.8（9.4）岁，种族分布相似。尽管 DC 和 YEM 的变化率相似，但动脉弹性标志物变化的预测因素因性别而异。在男性中，中国（P=0.002）和黑人（P=0.003）种族/民族、收缩压（P=0.012）和糖尿病（P=0.05）与 DC 更快下降（加速僵硬）有关。开始使用抗高血压药物与 DC 改善相关（P=0.03）；停止抗高血压药物与更快的僵硬（增加 YEM，P=0.05）相关。在女性中，较高的教育水平与较慢的僵硬（DC，P=0.041；YEM，P<0.001）以及使用降脂药物（P=0.03）相关，而基线使用抗高血压药物（YEM，P=0.01）和收缩压（DC，P=0.02；P=0.04）预测女性僵硬增加。
在两性中，颈动脉僵硬的纵向变化与收缩压和抗高血压治疗相关；然而，种族/民族（在男性中）和教育水平（在女性中）在两性之间可能有不同的贡献。
