McClendon Eric E, Musani Solomon K, Samdarshi Tandaw E, Khaire Sushant, Stokes Donny, Hamburg Naomi M, Sheffy Koby, Mitchell Gary F, Taylor Herman R, Benjamin Emelia J, Fox Ervin R
Department of Medicine, Wake Forest University, Salem, NC, USA.
Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
J Am Soc Hypertens. 2017 Jun;11(6):325-333.e2. doi: 10.1016/j.jash.2017.04.008. Epub 2017 May 4.
Digital vascular tone and function, as measured by peripheral arterial tonometry (PAT), are associated with cardiovascular risk and events in non-Hispanic whites. There are limited data on relations between PAT and cardiovascular risk in African-Americans. PAT was performed on a subset of Jackson Heart Study participants using a fingertip tonometry device. Resting digital vascular tone was assessed as baseline pulse amplitude. Hyperemic vascular response to 5 minutes of ischemia was expressed as the PAT ratio (hyperemic/baseline amplitude ratio). Peripheral augmentation index (AI), a measure of relative wave reflection, also was estimated. The association of baseline pulse amplitude (PA), PAT ratio, and AI to risk factors was assessed using stepwise multivariable models. The study sample consisted of 837 participants from the Jackson Heart Study (mean age, 54 ± 11 years; 61% women). In stepwise multivariable regression models, baseline pulse amplitude was related to male sex, body mass index, and diastolic blood pressure (BP), accounting for 16% of the total variability of the baseline pulse amplitude. Age, male sex, systolic BP, diastolic BP, antihypertensive medication, and prevalent cardiovascular disease contributed to 11% of the total variability of the PAT ratio. Risk factors (primarily age, sex, and heart rate) explained 47% of the total variability of the AI. We confirmed in our cohort of African-Americans, a significant relation between digital vascular tone and function measured by PAT and multiple traditional cardiovascular risk factors. Further studies are warranted to investigate the utility of these measurements in predicting clinical outcomes in African-Americans.
通过外周动脉张力测定法（PAT）测量的数字血管张力和功能与非西班牙裔白人的心血管风险及事件相关。关于非裔美国人中PAT与心血管风险之间关系的数据有限。使用指尖张力测定设备对杰克逊心脏研究的一部分参与者进行了PAT检测。静息数字血管张力被评估为基线脉搏振幅。对5分钟缺血的充血性血管反应表示为PAT比率（充血/基线振幅比率）。还估计了外周增强指数（AI），这是一种相对波反射的测量指标。使用逐步多变量模型评估基线脉搏振幅（PA）、PAT比率和AI与风险因素之间的关联。研究样本包括来自杰克逊心脏研究的837名参与者（平均年龄54±11岁；61%为女性）。在逐步多变量回归模型中，基线脉搏振幅与男性、体重指数和舒张压（BP）相关，占基线脉搏振幅总变异性的16%。年龄、男性、收缩压、舒张压、抗高血压药物和心血管疾病患病率占PAT比率总变异性的11%。风险因素（主要是年龄、性别和心率）解释了AI总变异性的47%。我们在非裔美国人队列中证实，通过PAT测量的数字血管张力和功能与多种传统心血管风险因素之间存在显著关系。有必要进一步研究这些测量方法在预测非裔美国人临床结局方面的效用。
