Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine.
Laboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
J Hypertens. 2018 Mar;36(3):537-543. doi: 10.1097/HJH.0000000000001590.
To investigate the relationship between common carotid artery diameter (CCA-D) and target organ damage (TOD) in essential hypertension.
A total of 200 essential hypertensive patients were enrolled (mean age 62.5 ± 9.5, men 59.0%) and were classified into two groups by the height-adjusted mean median of CCA-D: patients with CCA-D/height less than 3.905 mm/m (n = 100, 50%) and patients with CCA-D/height more than 3.905 mm/m (n = 100, 50%). Patients with CCA-D/height more than 3.905 mm/m have higher left ventricular mass index (LVMI) (P < 0.001) and higher prevalence of left ventricular hypertrophy (LVH) (P < 0.001), higher mean common carotid intima-media thickness (P = 0.008) and higher prevalence of carotid artery sclerosis (P = 0.03), higher pulse wave velocity (PWV) (P < 0.001) and higher prevalence of increased arterial stiffness (P = 0.01), higher urinary albumin/creatinine ratio (P = 0.001) and higher prevalence of microalbuminuria (P = 0.02) and greater number of TODs (P < 0.001) compared with the patients with CCA-D/height less than 3.905 mm/m. CCA-D was significantly correlated with LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio (r = 0.299, P < 0.001; r = 0.212, P = 0.007; r = 0.224, P = 0.005, respectively) after adjusting for cardiovascular risk factors. Multivariable stepwise linear regression analysis showed that number of TODs as well as individual TOD, including LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio, were independently correlated to height-adjusted mean CCA-D (all P < 0.05).
Height-adjusted mean CCA-D was an independent risk factor for individual TOD, including LVMI, PWV and urinary albumin/creatinine ratio, as well as overall number of TODs in essential hypertension.
探讨颈总动脉直径（CCA-D）与原发性高血压患者靶器官损害（TOD）之间的关系。
共纳入 200 例原发性高血压患者（平均年龄 62.5±9.5 岁，男性占 59.0%），根据校正身高的颈总动脉直径中位数将患者分为两组：CCA-D/身高＜3.905mm/m（n=100，50%）和 CCA-D/身高≥3.905mm/m（n=100，50%）。与 CCA-D/身高＜3.905mm/m 的患者相比，CCA-D/身高≥3.905mm/m 的患者左心室质量指数（LVMI）更高（P＜0.001），左心室肥厚（LVH）的发生率更高（P＜0.001），颈总动脉内膜-中层厚度（CCA-IMT）均值更高（P=0.008），颈动脉粥样硬化的发生率更高（P=0.03），脉搏波速度（PWV）更高（P＜0.001），动脉僵硬度增加的发生率更高（P=0.01），尿白蛋白/肌酐比值（UACR）更高（P=0.001），微量白蛋白尿的发生率更高（P=0.02），TOD 数量更多（P＜0.001）。校正心血管危险因素后，CCA-D 与 LVMI、PWV 和 UACR 呈显著正相关（r=0.299，P＜0.001；r=0.212，P=0.007；r=0.224，P=0.005）。多元逐步线性回归分析显示，TOD 数量以及包括 LVMI、PWV 和 UACR 在内的各 TOD 与校正身高后的 CCA-D 均值独立相关（均 P＜0.05）。
校正身高后的 CCA-D 均值是原发性高血压患者包括 LVMI、PWV 和 UACR 在内的各 TOD 以及 TOD 总数的独立危险因素。
