Curcio S, García-Espinosa V, Castro J M, Peluso G, Marotta M, Arana M, Chiesa P, Giachetto G, Bia D, Zócalo Yanina
Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay.
Basic Medicine Department, Faculty of Medicine, Clinical Hospital, Republic University, Avenida Italia w/n, 11600, Montevideo, Uruguay.
Pediatr Cardiol. 2017 Apr;38(4):840-852. doi: 10.1007/s00246-017-1591-z. Epub 2017 Mar 13.
The aims of the study were to determine (1) whether the presence of High blood pressure (HBP) states in the youth associate a steeper rate of age-related change in arterial geometrical and wall properties with respect to subjects with no previous cardiovascular risk factor (CRF) exposure, (2) in which parameters and in what magnitude, and (3) the existence of a gender-related difference in the impact of this condition on arterial properties. 300 individuals (mean/range: 15/4-29 years; 133 females) were included. Two groups were assembled: (1) Reference: nonprevious exposure to traditional CRF and (2) HBP: subjects with arterial hypertension and/or elevated blood pressure (BP) levels during the study. Additionally, HBP subjects were separated in BP-related subgroups. Measured parameters were (1) central (aortic) arterial BP and aortic pulse wave analysis parameters, (2) carotid and femoral artery local (pressure-strain elastic modulus) and regional (pulse wave velocity; PWV) stiffness, and (3) arterial diameters and carotid intima-media thickness (CIMT). Age-related changes in these parameters (absolute values and z-scores) were explored by obtaining simple linear regression models for each group. HBP presented a steeper rate of change (accelerated vascular aging; VA) for most of the parameters assessed, mainly in central (aortic) hemodynamics. VA increased as the HBP level got higher. Both males' and females' aging rates were affected by this condition, but females presented a more marked relative age-related increase with HBP exposure. HBP states in the youth gradually associate accelerated VA, with a progressive hemodynamic-structural-functional onset of damage, with females presenting a more marked relative HBP-associated arterial repercussion.
(1)与未曾暴露于心血管危险因素(CRF)的受试者相比,青年人群中高血压(HBP)状态是否与动脉几何结构和管壁特性的年龄相关变化率更高有关;(2)涉及哪些参数以及变化幅度如何;(3)这种情况对动脉特性的影响是否存在性别差异。研究纳入了300名个体(平均/范围:15/4 - 29岁;133名女性)。分为两组:(1)对照组:未曾暴露于传统CRF;(2)HBP组:研究期间患有动脉高血压和/或血压(BP)水平升高的受试者。此外,HBP受试者按血压相关亚组进行划分。测量参数包括:(1)中心(主动脉)动脉血压和主动脉脉搏波分析参数;(2)颈动脉和股动脉局部(压力 - 应变弹性模量)和区域(脉搏波速度;PWV)僵硬度;(3)动脉直径和颈动脉内膜中层厚度(CIMT)。通过为每组建立简单线性回归模型来探索这些参数的年龄相关变化(绝对值和z分数)。对于大多数评估参数,HBP呈现出更陡峭的变化率(加速血管老化;VA),主要体现在中心(主动脉)血流动力学方面。VA随着HBP水平升高而增加。这种情况影响了男性和女性的衰老速率,但女性在暴露于HBP时呈现出更明显的相对年龄相关增加。青年人群中的HBP状态逐渐与加速的VA相关联,伴随着损害的血流动力学 - 结构 - 功能逐渐发生,女性呈现出更明显的与HBP相关的动脉反应。