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体质指数与中国原发性高血压成年人动脉僵硬度呈负相关:来自中国脑卒中一级预防试验(CSPPT)的结果。

Body mass index is inversely associated with arterial stiffness in Chinese adults with primary hypertension: results from the China Stroke Primary Prevention Trial (CSPPT).

机构信息

a Department of Cardiovascular Diseases , Peking University First Hospital , Beijing , China.

b National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division , Nanfang Hospital, Southern Medical University , Guangzhou , China.

出版信息

Clin Exp Hypertens. 2017;39(5):394-401. doi: 10.1080/10641963.2016.1254226. Epub 2017 May 23.

Abstract

BACKGROUND

This study aimed to elucidate the relationship between body mass index (BMI) and the presence of arterial stiffness in rural-dwelling Chinese adults with primary hypertension.

METHODS

Primary hypertension patients (n = 19,375) receiving an average of 4.5 years of antihypertension therapy were selected from the Chinese Stroke Primary Prevention Trial (mean age: 64.7 ± 7.4 years, male: 37.8%). Anthropometric, demographic, hemodynamic, and biochemical data were obtained. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV).

RESULTS

BMI was inversely associated with baPWV after adjusting for gender, age, smoking, alcohol consumption, center, pulse, SBP, DBP, FBG, TC, TG, HDL-C, BUN, Scr, UA, HCY, antidiabetes treatment, lipid-lowing treatment, and antihypertensive treatment (β (SE): -10.72 (0.69), P < 0.0001). Quintile1 (Q1) was used as a reference; Q2, Q3, Q4, and Q5 groups were all inversely associated with baPWV. The β increased with increasing BMI, β (SE) was -20.29 (6.74), -30.66 (7.01), -51.82 (7.27), and -103.1 (7.62), respectively, for Q2 - Q5, P < 0.05. BMI remained inversely correlated with baPWV across differences in gender, center, blood pressure, lipid levels, and the presence or absence of diabetes subgroups.

CONCLUSION

Increased BMI is a positive factor against the development of arterial stiffness in Chinese rural-dwelling adults with primary hypertension undergoing antihypertension treatments, after adjusting for confounding factors.

摘要

背景

本研究旨在阐明体重指数(BMI)与原发性高血压农村居民动脉僵硬之间的关系。

方法

从中国脑卒中一级预防试验中选择了 19375 名接受平均 4.5 年降压治疗的原发性高血压患者(平均年龄:64.7±7.4 岁,男性:37.8%)。获取了人体测量、人口统计学、血流动力学和生化数据。使用臂踝脉搏波速度(baPWV)评估动脉僵硬。

结果

在调整性别、年龄、吸烟、饮酒、中心、脉搏、SBP、DBP、FBG、TC、TG、HDL-C、BUN、Scr、UA、HCY、抗糖尿病治疗、降脂治疗和降压治疗后,BMI 与 baPWV 呈负相关(β(SE):-10.72(0.69),P<0.0001)。将五分位数 1(Q1)作为参考;Q2、Q3、Q4 和 Q5 组均与 baPWV 呈负相关。随着 BMI 的增加,β(SE)分别为-20.29(6.74)、-30.66(7.01)、-51.82(7.27)和-103.1(7.62),Q2-Q5 之间的差异有统计学意义(P<0.05)。在性别、中心、血压、血脂水平以及是否存在糖尿病亚组中,BMI 与 baPWV 呈负相关。

结论

在调整混杂因素后,中国农村原发性高血压降压治疗患者 BMI 升高是动脉僵硬发展的一个正向因素。

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