Tautu Oana-Florentina, Darabont Roxana, Onciul Sebastian, Deaconu Alexandru, Comanescu Ioana, Andrei Radu Dan, Dragoescu Bogdan, Cinteza Mircea, Dorobantu Maria
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Cardiology, Clinical Emergency Hospital Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Department of Cardiology, Emergency University Hospital, Bucharest, Romania.
Maedica (Bucur). 2014 Jun;9(2):127-34.
To analyze the predictive value of new cardiovascular (CV) risk factors for CV risk assessment in the adult Romanian hypertensive (HT) population.
Hypertensive adults aged between 40-65 years of age, identified in national representative SEPHAR II survey were evaluated by anthropometric, BP and arterial stiffness measurements: aortic pulse wave velocity (PWVao), aortic augmentation index (AIXao), revers time (RT) and central systolic blood pressure (SBPao), 12 lead ECGs and laboratory workup. Values above the 4th quartile of mean SBP' standard deviation (s.d.) defined increased BP variability. Log(TG/HDL-cholesterol) defined atherogenic index of plasma (AIP). Serum uric acid levels above 5.70 mg/dl for women and 7.0 mg/dl for males defined hyperuricemia (HUA). CV risk was assessed based on SCORE chart for high CV risk countries. Binary logistic regression using a stepwise likelihood ratio method (adjustments for major confounders and colliniarity analysis) was used in order to validate predictors of high and very high CV risk class.
The mean SBP value of the study group was 148.46±19.61 mmHg. Over forty percent of hypertensives had a high and very high CV risk. Predictors of high/very high CV risk category validated by regression analysis were: increased visit-to-visit BP variability (OR: 2.49; 95%CI: 1.67-3.73), PWVao (OR: 1.12; 95%CI: 1.02-1.22), RT (OR: 0.95; 95% CI: 0.93-0.98), SBPao (OR: 1.01; 95%CI: 1.01-1.03) and AIP (OR: 7.08; 95%CI: 3.91-12.82).
The results of our study suggests that the new CV risk factors such as increased BP variability, arterial stiffness indices and AIP are useful tools for a more accurate identification of hypertensives patients at high and very high CV risk.
分析新的心血管（CV）危险因素对罗马尼亚成年高血压（HT）人群CV风险评估的预测价值。
在具有全国代表性的SEPHAR II调查中确定的40 - 65岁成年高血压患者，通过人体测量、血压和动脉僵硬度测量进行评估：主动脉脉搏波速度（PWVao）、主动脉增强指数（AIXao）、反向时间（RT）和中心收缩压（SBPao）、12导联心电图和实验室检查。平均收缩压标准差（s.d.）高于第4四分位数的值定义为血压变异性增加。Log（甘油三酯/高密度脂蛋白胆固醇）定义为血浆致动脉粥样硬化指数（AIP）。女性血清尿酸水平高于5.70 mg/dl，男性高于7.0 mg/dl定义为高尿酸血症（HUA）。基于高CV风险国家的SCORE图表评估CV风险。使用逐步似然比方法（对主要混杂因素进行调整和共线性分析）的二元逻辑回归用于验证高和非常高CV风险类别的预测因素。
研究组的平均收缩压值为148.46±19.61 mmHg。超过40%的高血压患者具有高和非常高的CV风险。通过回归分析验证的高/非常高CV风险类别的预测因素为：就诊间血压变异性增加（OR：2.49；95%CI：1.67 - 3.73）、PWVao（OR：1.12；95%CI：1.02 - 1.22）、RT（OR：0.95；95%CI：0.93 - 0.98）、SBPao（OR：1.01；95%CI：1.01 - 1.03）和AIP（OR：7.08；95%CI：3.91 - 12.82）。
我们的研究结果表明，新的CV危险因素，如血压变异性增加、动脉僵硬度指数和AIP，是更准确识别高和非常高CV风险高血压患者的有用工具。
