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哮喘的历史:从儿童时期到无症状年轻成年人的动脉僵硬度:博加卢萨心脏研究。

History of Asthma From Childhood and Arterial Stiffness in Asymptomatic Young Adults: The Bogalusa Heart Study.

机构信息

From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., X.L., Y.H., H.N., F.R., T.K., E.H., S.L., J.H., L.B., W.C., L.Q.); Department of Public Health, Faculty of Medicine and Health Sciences, Syarif Hidayatullah State Islamic University, Jakarta, Indonesia (H.N.); Children's Hospital New Orleans, LA (X.S.); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (L.Q.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (L.Q.).

出版信息

Hypertension. 2018 May;71(5):928-936. doi: 10.1161/HYPERTENSIONAHA.118.10916.

Abstract

Asthma is related to various cardiovascular risk. Whether a history of asthma from childhood contributes to arterial stiffness in adulthood, a noninvasive surrogate for cardiovascular events, is unknown. Prospective analyses were performed among 1746 Bogalusa Heart Study participants aged 20 to 51 years with data on self-report asthma collected since childhood. Aorta-femoral pulse wave velocity (af-PWV, m/s) was repeatedly assessed among adults ≥aged 18 years. Generalized linear mixed models and generalized linear models were fitted for the repeated measurements of af-PWV and its changes between the last and the first measurements, respectively. After a median follow-up of 11.1 years, participants with a history of asthma from childhood had a higher af-PWV (6.78 versus 6.13; =0.048) and a greater increase in af-PWV (8.99 versus 2.95; =0.043) than those without asthma, adjusted for age, sex, race, smoking status, heart rate, body mass index, systolic blood pressure, lipids, and glycemia. In addition, we found significant interactions of asthma with body mass index and systolic blood pressure on af-PWV and its changes ( for interaction <0.01). The associations of asthma with af-PWV and its changes appeared to be stronger among participants who were overweight and obese (body mass index ≥25 kg/m) or with prehypertension and hypertension (systolic blood pressure ≥120 mm Hg) compared with those with a normal body mass index or systolic blood pressure. Our findings indicate that a history of asthma from childhood is associated with higher af-PWV and greater increases in af-PWV, and such associations are stronger among young adults who are overweight or with elevated blood pressure.

摘要

哮喘与多种心血管风险相关。从儿童时期就患有哮喘是否会导致成年后动脉僵硬,这是心血管事件的一个非侵入性替代指标,目前尚不清楚。对 1746 名 20 至 51 岁的博加卢萨心脏研究参与者进行了前瞻性分析,这些参与者从儿童时期开始就有关于哮喘的自我报告数据。在年龄≥18 岁的成年人中,反复评估主动脉-股动脉脉搏波速度(af-PWV,m/s)。分别使用广义线性混合模型和广义线性模型对 af-PWV 的重复测量值及其在最后一次和第一次测量之间的变化进行拟合。在中位随访 11.1 年后,与没有哮喘的参与者相比,有儿童时期哮喘病史的参与者的 af-PWV 更高(6.78 与 6.13;=0.048),af-PWV 的增加幅度更大(8.99 与 2.95;=0.043),调整年龄、性别、种族、吸烟状况、心率、体重指数、收缩压、血脂和血糖后。此外,我们发现哮喘与 af-PWV 及其变化之间存在显著的交互作用(<0.01)。与体重指数和收缩压正常的参与者相比,超重和肥胖(体重指数≥25kg/m)或存在高血压前期和高血压(收缩压≥120mmHg)的参与者中,哮喘与 af-PWV 及其变化的相关性更强。我们的研究结果表明,儿童时期的哮喘史与较高的 af-PWV 以及 af-PWV 的更大增加有关,而且在超重或血压升高的年轻成年人中,这种关联更强。

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