Gottsäter Mikael, Östling Gerd, Persson Margaretha, Engström Gunnar, Melander Olle, Nilsson Peter M
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
J Hypertens. 2015 May;33(5):957-65. doi: 10.1097/HJH.0000000000000520.
Arterial stiffness plays a fundamental role in the development of hypertension and is a risk factor for both cardiovascular disease and mortality. The stiffening that occurs with increasing age has, in numerous cross-sectional studies, been shown to be associated with several cardiovascular risk factors. This observational study aims to characterize the predictive and cross-sectional markers focusing on the non-hemodynamic component of arterial stiffness.
In all, 2679 men and women from Malmö, Sweden, were examined at baseline during 1991-1994, and again at follow-up during 2007-2012 (mean age 72 years, 38% men). Follow-up examination included measurement of arterial stiffness by carotid-femoral pulse wave velocity (c-fPWV), after a mean period of 17 years. The associations between c-fPWV and risk markers were calculated with multiple linear regression.
The results indicated that for both sexes, waist circumference (β = 0.17, P < 0.001), fasting glucose (β = 0.13, P < 0.001), Homeostatic Model Assessment - Insulin Resistance (β = 0.10, P < 0.001), triglycerides (β = 0.10, P < 0.001), and high-density lipoprotein cholesterol (β = -0.08, P < 0.001) were all predictors of cfPWV adjusted for mean arterial pressure and heart rate, as well as for classical cardiovascular risk factors and drug treatment. There were no associations between baseline or follow-up low-density lipoprotein cholesterol, smoking, or eGFR and c-fPWV.
The non-hemodynamic cluster of risk markers and predictors of arterial stiffness in a middle-aged population includes abdominal obesity, hyperglycemia, and dyslipidemia, but not smoking and low-density lipoprotein cholesterol. This pattern existed in both sexes.
动脉僵硬度在高血压的发生发展中起重要作用,是心血管疾病和死亡的危险因素。在众多横断面研究中,随年龄增长出现的动脉僵硬已被证明与多种心血管危险因素相关。这项观察性研究旨在确定聚焦于动脉僵硬度非血流动力学成分的预测性和横断面标志物。
1991年至1994年期间,对瑞典马尔默的2679名男性和女性进行了基线检查,并于2007年至2012年进行了随访(平均年龄72岁,男性占38%)。随访检查包括在平均17年后通过颈股脉搏波速度(c-fPWV)测量动脉僵硬度。采用多元线性回归计算c-fPWV与风险标志物之间的关联。
结果表明,对于男性和女性,在校正平均动脉压、心率以及经典心血管危险因素和药物治疗后,腰围(β = 0.17,P < 0.001)、空腹血糖(β = 0.13,P < 0.001)、稳态模型评估-胰岛素抵抗(β = 0.10,P < 0.001)、甘油三酯(β = 0.10,P < 0.001)和高密度脂蛋白胆固醇(β = -0.08,P < 0.001)均为c-fPWV的预测因素。基线或随访时的低密度脂蛋白胆固醇、吸烟或估算肾小球滤过率(eGFR)与c-fPWV之间无关联。
中年人群中动脉僵硬度的非血流动力学风险标志物和预测因素包括腹部肥胖、高血糖和血脂异常,但不包括吸烟和低密度脂蛋白胆固醇。这种模式在男性和女性中均存在。