Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai.
Institute of Clinical Epidemiology and Evidence-Based Medicine, Tongji University, Shanghai, China.
J Hypertens. 2018 Jun;36(6):1391-1398. doi: 10.1097/HJH.0000000000001692.
Vascular aging represents a mediating step between risk factors and cardiovascular events, and preclinical target organ damage (TOD) integrates the cumulative effect of cardiovascular risk factors. This study is aimed at the relationships between vascular aging and TOD.
Two thousand and ninety-eight participants (45.52% men, aged 71.3 ± 6.1 years) were recruited from June 2014 to June 2017 from the communities in the northern Shanghai area. Preclinical TOD was assessed in all the participants. Other clinical information was obtained by standard questionnaire. Healthy vascular aging (HVA) was defined as absence of hypertension and a relatively normal carotid-femoral PWV based on participants' age and blood pressure. We fitted logistic regression models to assess the probability of non-HVA in association with all the preclinical TOD.
Six hundred and forty-two (30.6%) elderly participants had HVA, and the prevalence of HVA decreased from 30.84% (aged 65-66) to 20.72% (aged ≥75). Increased age, increased SBP, metabolic syndrome, increased BMI and family history of premature cardiovascular disease (CVD) were significantly associated with accelerated vascular aging (P = 0.031 to P < 0.001). After multivariate adjustments, accelerated vascular aging was associated with left ventricular diastolic dysfunction (LVDD; OR (95% CI) 1.83 (1.23, 2.71), P = 0.003), left ventricular hypertrophy (LVH; OR (95% CI) 1.97 (1.54, 2.51), P < 0.001) and micro-albuminuria (MAU; OR (95% CI) 1.66 (1.35, 2.03), P < 0.001).
Management of blood pressure and metabolic profile may help to alleviate vascular aging and accelerated vascular aging is associated with LVH, LVDD and MAU, which may serve as a potential target to reverse cardiac and renal TOD.
血管衰老代表了危险因素与心血管事件之间的中介步骤，而临床前靶器官损伤（TOD）则综合了心血管危险因素的累积效应。本研究旨在探讨血管衰老与 TOD 之间的关系。
2098 名参与者（45.52%为男性，年龄 71.3±6.1 岁）于 2014 年 6 月至 2017 年 6 月从上海北部社区招募。所有参与者均进行了临床前 TOD 评估。其他临床信息通过标准问卷获得。健康血管衰老（HVA）定义为无高血压且根据参与者年龄和血压，颈动脉-股动脉 PWV 相对正常。我们拟合逻辑回归模型，以评估非 HVA 与所有临床前 TOD 之间的关联概率。
642 名（30.6%）老年参与者存在 HVA，且 HVA 的患病率从 30.84%（65-66 岁）降至 20.72%（≥75 岁）。年龄增加、SBP 升高、代谢综合征、BMI 增加和早发性心血管疾病（CVD）家族史与血管加速老化显著相关（P=0.031 至 P<0.001）。经过多变量调整后，加速血管老化与左心室舒张功能障碍（LVDD；比值比[95%CI]为 1.83[1.23，2.71]，P=0.003）、左心室肥厚（LVH；比值比[95%CI]为 1.97[1.54，2.51]，P<0.001）和微量白蛋白尿（MAU；比值比[95%CI]为 1.66[1.35，2.03]，P<0.001）相关。
血压和代谢谱的管理可能有助于减轻血管衰老，加速血管衰老与 LVH、LVDD 和 MAU 相关，这可能成为逆转心脏和肾脏 TOD 的潜在靶点。
