理想心血管健康的累积暴露与动脉僵硬度之间的关联。
Association between cumulative exposure to ideal cardiovascular health and arterial stiffness.
作者信息
Zheng Xiaoming, Zhang Ruiying, Liu Xiaoxue, Zhao Haiyan, Liu Hongmin, Gao Jingsheng, Wu Yuntao, Wu Shouling
机构信息
Department of Cardiology, Kailuan Hospital, Tangshan, China.
Department of Cardiology, Kailuan Hospital, Tangshan, China; Graduate School, North China University of Science and Technology, Tangshan, China.
出版信息
Atherosclerosis. 2017 May;260:56-62. doi: 10.1016/j.atherosclerosis.2017.03.018. Epub 2017 Mar 25.
BACKGROUND AND AIMS
Ideal cardiovascular health (CVH) is associated with reduced risk of cardiac and cerebral events. Arterial stiffness plays an important role in the progress of cardiac and cerebral events, but it is unclear whether ideal CVH, in particular, cumulative exposure to ideal CVH (cumCVH), is associated with reduced risk of arterial stiffness. We examined the association between cumCVH and arterial stiffness using data from the Kailuan Study.
METHODS
The study cohort consisted of 20,355 participants from the Kailuan community-based cohort, whose mean follow-up period was 3.36 years since baseline (visit 3). CumCVH was calculated as the summed average ideal CVH score between two consecutive visits, multiplied by the time between the two consecutive visits in years. Multivariable linear regression model analysis was used to evaluate the relationship between cumCVH and brachial ankle pulse wave velocity (baPWV).Variance inflation factor (VIF) was calculated to diagnose co-linearity between multiple variables. We also used logistic regression to evaluate the association between cumCVH and arterial stiffness by calculating the crude odds ratio (OR) and adjusted OR, with 95% confidence interval (CI). Sensitivity analysis was performed to test the robustness of our findings.
RESULTS
The participants were classified into 5 groups according to the quintile of cumCVH exposure levels. Multivariate linear regression analysis showed that cumCVH had a significant inverse linear relationship with baPWV (B = -3.35, p < 0.001). The result of logistic regression demonstrated that compared with Q1 group,Q3, Q4, Q5 were associated with a 15%, 24%, 36% significantly lower incidence of arterial stiffness, after adjusting for confounders.What is more, the results of sensitivity analysis had no influence on our results.
CONCLUSIONS
Exposure to higher cumCVH can prevent the increase in baPWV and reduce the incidence of arterial stiffness.
背景与目的
理想心血管健康状态（CVH）与降低心脑血管事件风险相关。动脉僵硬度在心血管事件进展中起重要作用，但尚不清楚理想CVH，尤其是累积暴露于理想CVH（cumCVH）是否与降低动脉僵硬度风险相关。我们利用开滦研究的数据，检验了cumCVH与动脉僵硬度之间的关联。
方法
研究队列包括来自开滦社区队列的20355名参与者，自基线（第3次访视）起平均随访期为3.36年。CumCVH计算为两次连续访视之间理想CVH得分的平均总和，乘以两次连续访视之间的时间（年）。采用多变量线性回归模型分析评估cumCVH与臂踝脉搏波速度（baPWV）之间的关系。计算方差膨胀因子（VIF）以诊断多个变量之间的共线性。我们还使用逻辑回归，通过计算粗比值比（OR）和调整后的OR以及95%置信区间（CI），评估cumCVH与动脉僵硬度之间的关联。进行敏感性分析以检验我们研究结果的稳健性。
结果
根据cumCVH暴露水平的五分位数将参与者分为5组。多变量线性回归分析显示，cumCVH与baPWV呈显著负线性关系（B = -3.35，p < 0.001）。逻辑回归结果表明，与第1组相比，在调整混杂因素后，第3、4、5组动脉僵硬度的发生率显著降低15%、24%、36%。此外，敏感性分析结果对我们的结果没有影响。
结论
累积暴露于更高的cumCVH可防止baPWV升高并降低动脉僵硬度的发生率。
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