Melton Charles David, Luo Ruiyan, Wong Brett J, Spasojevic Ivan, Wagenknecht Lynne E, D'Agostino Ralph B, Il'yasova Dora
School of Public Health, Georgia State University, Atlanta.
Department of Kinesiology & Health, Georgia State University, Atlanta.
Ann Epidemiol. 2017 Jun;27(6):391-396. doi: 10.1016/j.annepidem.2017.05.005. Epub 2017 May 17.
There is strong biological plausibility for a causal role of reactive oxygen species in vascular pathology but no direct epidemiological evidence linking elevated reactive oxygen species levels to hypertension development. We examined cross-sectional and prospective associations between oxidative status (urinary F-isoprostanes) and hypertension in the Insulin Resistance Atherosclerosis Study cohort (n = 831).
The cohort included non-Hispanic white, Hispanic, and non-Hispanic black individuals, with 252 (30%) having prevalent hypertension and 579 participants normotensive at baseline, 122 (21%) of whom developed hypertension during the 5-year follow-up. Four urinary F-isoprostane isomers were quantified in baseline specimens using LC/MS-MS and were summarized as a composite index. Examined outcomes included hypertension status (yes/no), systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP).
Prevalent and incident hypertension were associated with greater age, Black race, impaired glucose tolerance, and greater BMI. F-IsoP levels were lower among men and among non-Hispanic Blacks, were inversely associated with age, and were directly associated with BMI. No cross-sectional association was found between F-isoprostanes and hypertension status (OR = 0.93, 0.77-0.12). Among the continuous measures of blood pressure only PP was associated with F-isoprostanes at baseline (beta-coefficient = 0.99, 0.11-1.86). No prospective association was found between F-isoprostanes and incident hypertension: OR = 0.98, 0.77-1.25. No prospective associations were found for systolic blood pressure and diastolic blood pressure, and pulse pressure. Mean arterial pressure showed an inverse association (beta-coefficient = -0.16, -0.31 to -0.01).
Elevated F-isoprostane levels do not increase the risk of hypertension.
活性氧在血管病变中起因果作用具有很强的生物学合理性，但尚无直接的流行病学证据表明活性氧水平升高与高血压的发生有关。我们在胰岛素抵抗动脉粥样硬化研究队列（n = 831）中研究了氧化状态（尿F-异前列腺素）与高血压之间的横断面和前瞻性关联。
该队列包括非西班牙裔白人、西班牙裔和非西班牙裔黑人个体，其中252人（30%）患有高血压，579名参与者在基线时血压正常，其中122人（21%）在5年随访期间患高血压。使用液相色谱/质谱联用仪对基线样本中的四种尿F-异前列腺素异构体进行定量，并汇总为一个综合指数。研究的结局包括高血压状态（是/否）、收缩压（SBP）和舒张压（DBP）、脉压（PP）和平均动脉压（MAP）。
高血压的患病率和发病率与年龄较大、黑人种族、糖耐量受损和较高的体重指数有关。F-异前列腺素水平在男性和非西班牙裔黑人中较低，与年龄呈负相关，与体重指数呈正相关。未发现F-异前列腺素与高血压状态之间存在横断面关联（OR = 0.93，0.77 - 0.12）。在血压的连续测量指标中，仅基线时的脉压与F-异前列腺素有关（β系数 = 0.99，0.11 - 1.86）。未发现F-异前列腺素与高血压发病之间存在前瞻性关联：OR = 0.98，0.77 - 1.25。未发现收缩压、舒张压和脉压存在前瞻性关联。平均动脉压呈负相关（β系数 = -0.16，-0.31至-0.01）。
F-异前列腺素水平升高不会增加患高血压的风险。
