Zhang Y J, Wu S L, Li H Y, Zhao Q H, Ning C H, Zhang R Y, Yu J X, Li W, Chen S H, Gao J S
Department of Cardiology, Kailuan Hospital, Tangshan 063000, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Jan 24;46(1):56-63. doi: 10.3760/cma.j.issn.0253-3758.2018.01.010.
To investigate the impact of blood pressure and age on arterial stiffness in general population. Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (11 608), 45-59 years group (12 757), above 60 years group (5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(39.30, 0.001), and same results were found in the sub-age groups (-value was 37.72, 27.30, 9.15, all 0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the s were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.
探讨血压和年龄对一般人群动脉僵硬度的影响。纳入参加2010年、2012年和2014年开滦健康体检的参与者。分析肱踝脉搏波速度(baPWV)检查数据。根据世界卫生组织年龄标准,将参与者分为3个年龄组:18 - 44岁组(11608人)、45 - 59岁组(12757人)、60岁以上组(5002人)。根据高血压诊断标准(2010年中国高血压防治指南),将参与者进一步分为高血压组和非高血压组。采用多重线性回归分析总参与者中收缩压(SBP)与baPWV之间的关联,然后按年龄组分层分析。采用多因素logistic回归模型分析血压对各组动脉僵硬度(baPWV≥1400 cm/s)的影响。(1)所有参与者的基线特征:35350名参与者完成了2010年、2012年和2014年开滦体检并参加了baPWV检查。排除2237名无血压测量值的参与者,排除1569名有外周动脉疾病史的参与者,还排除1016名有心脑血管疾病史的参与者。分析29367名参与者的数据。年龄为(48.0±12.4)岁,男性21305名(72.5%)。(2)各年龄组baPWV分布:baPWV随年龄增长而升高。在非高血压人群中,18 - 44岁组、45 - 59岁组、60岁以上组的baPWV分别为:1299.3、1428.7和1704.6 cm/s。对于高血压参与者,baPWV的相应值分别为:1498.4、1640.7和1921.4 cm/s。各年龄组高血压组的baPWV均显著高于非高血压组(P<0.05)。(3)多重线性回归分析确定baPWV的危险因素:多因素线性回归分析显示,baPWV与SBP呈正相关(β=39.30,P=0.001),在调整包括年龄、性别、脉压(PP)、体重指数(BMI)、空腹血糖(FBG)、总胆固醇(TC)、吸烟、饮酒、体育锻炼、降压药物、降脂药物等其他混杂因素后,各年龄亚组也得到相同结果(β值分别为37.72、27.30、9.15,P均为0.001)。(4)baPWV相关因素的多因素logistic回归分析:在调整包括年龄、性别、PP、BMI、FBG、TC、吸烟、饮酒、体育锻炼、降压药物、降脂药物等其他混杂因素后,多因素logistic回归分析显示,高血压组动脉僵硬度增加的风险高于非高血压组,总参与者中高血压患者的比值比为2.54(2.35 - 2.74),各年龄亚组也得到相同结果,各年龄亚组的比值比分别为3.22(2.86 - 3.63)、2.48(2.23 - 2.76)和1.91(1.42 - 2.56)。不同年龄组SBP与动脉僵硬度呈正相关,高血压是不同年龄组动脉僵硬度增加的危险因素。临床试验注册中国临床试验注册中心,ChiCTR - TNC - 11001489