Faconti Luca, Silva Maria J, Molaodi Oarabile R, Enayat Zinat E, Cassidy Aidan, Karamanos Alexis, Nanino Elisa, Read Ursula M, Dall Philippa, Stansfield Ben, Harding Seeromanie, Cruickshank Kennedy J
aDiabetes & Nutritional Sciences Division, King's College London; Cardiovascular and Social Epidemiology Groups, London bMRC/CSO Social and Public Health Sciences Unit, University of Glasgow cInstitute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
J Hypertens. 2016 Nov;34(11):2220-6. doi: 10.1097/HJH.0000000000001066.
Traditional cardiovascular risk factors do not fully account for ethnic differences in cardiovascular disease. We tested if arterial function indices, particularly augmentation index (AIx), and their determinants from childhood could underlie such ethnic variability among young British adults in the 'DASH' longitudinal study.
DASH, at http://dash.sphsu.mrc.ac.uk/, includes representative samples of six main British ethnic groups. Pulse wave velocity (PWV) and AIx were recorded using the Arteriograph device at ages 21-23 years in a subsample (n = 666); psychosocial, anthropometric, and blood pressure (BP) measures were collected then and in two previous surveys at ages 11-13 years and 14-16 years. For n = 334, physical activity was measured over 5 days (ActivPal).
Unadjusted values and regression models for PWVs were similar or lower in ethnic minority than in White UK young adults, whereas AIx was higher - Caribbean (14.9, 95% confidence interval 12.3-17.0%), West African (15.3, 12.9-17.7%), Indian (15.1, 13.0-17.2%), and Pakistani/Bangladeshi (15.7, 13.7-17.7%), compared with White UK (11.9, 10.2-13.6%). In multivariate models, adjusted for sex, central SBP, height, and heart rate, Indian and Pakistani/Bangladeshi young adults had higher AIx (β = 3.35, 4.20, respectively, P < 0.01) than White UK with a similar trend for West Africans and Caribbeans but not statistically significant. Unlike PWV, physical activity, psychosocial or deprivation measures were not associated with AIx, with borderline associations from brachial BP but no other childhood variables.
Early adult AIx, but not arterial stiffness, may be a useful tool for testing components of excess cardiovascular risk in some ethnic minority groups.
传统心血管危险因素不能完全解释心血管疾病的种族差异。在“DASH”纵向研究中，我们测试了动脉功能指标，特别是增强指数（AIx）及其童年时期的决定因素，是否能解释英国年轻成年人中的这种种族差异。
DASH可在http://dash.sphsu.mrc.ac.uk/获取，包含六个主要英国种族群体的代表性样本。在一个子样本（n = 666）中，于21至23岁时使用动脉造影仪记录脉搏波速度（PWV）和AIx；当时以及之前在11至13岁和14至16岁时的两次调查中收集了心理社会、人体测量和血压（BP）测量数据。对于n = 334，通过ActivPal测量了5天的身体活动情况。
未调整值和PWV回归模型在少数族裔中与英国白人年轻成年人相似或更低，而AIx更高——与英国白人（11.9，95%置信区间10.2 - 13.6%）相比，加勒比裔（14.9，95%置信区间12.3 - 17.0%）、西非裔（15.3，12.9 - 17.7%）、印度裔（15.1，13.0 - 17.2%）和巴基斯坦/孟加拉裔（15.7，13.7 - 17.7%）。在多变量模型中，调整性别、中心收缩压、身高和心率后，印度裔和巴基斯坦/孟加拉裔年轻成年人的AIx更高（β分别为3.35、4.20，P < 0.01），高于英国白人，西非裔和加勒比裔有类似趋势但无统计学意义。与PWV不同，身体活动、心理社会或贫困测量与AIx无关，肱动脉血压有临界关联，但其他童年变量无此关联。
成年早期的AIx而非动脉僵硬度，可能是检测某些少数族裔群体心血管风险过高因素的有用工具。
