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儿童时期的脉压可预测成年后的亚临床血管损伤:北京血压队列研究。

Childhood pulse pressure predicts subclinical vascular damage in adulthood: the Beijing Blood Pressure Cohort Study.

出版信息

J Hypertens. 2018 Aug;36(8):1663-1670. doi: 10.1097/HJH.0000000000001748.

Abstract

OBJECTIVE

We aimed to investigate associations of childhood pulse pressure (PP) and change in PP status with adult subclinical vascular damage.

METHODS

Data were obtained from a population-based cohort of children aged 6-18 years started in 1987. The study constituted 1254 participants who were followed up in 2010-2011 (aged 28-42 years). Carotid arteriosclerosis and aortic stiffness were assessed by carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV), respectively.

RESULTS

Both childhood PP and mean arterial pressure (MAP) were independently associated with adult carotid IMT and PWV adjusted for sex, childhood age, follow-up duration, and other traditional cardiovascular risk factors. After further adjustment for adult values of PP and MAP, childhood PP was still associated with adult carotid IMT but not with PWV, whereas childhood MAP was associated with adult PWV but not with carotid IMT. In addition, compared with participants who had normal PP in both childhood and adulthood, participants who had high PP in adulthood, irrespective of their childhood PP status, had higher levels of carotid IMT and PWV (all P < 0.05). Participants who had high PP in childhood and normal PP in adulthood also had higher levels of adult carotid IMT but similar levels of PWV compared with participants who had consistently normal PP.

CONCLUSION

Large PP in childhood plays an important role in the development of subclinical vascular damage in adulthood. These findings underscore the importance of early prevention of large PP to reduce future risk of cardiovascular disease.

摘要

目的

我们旨在研究儿童脉压(PP)和 PP 状态变化与成人亚临床血管损伤的相关性。

方法

数据来自于 1987 年开始的一项基于人群的儿童队列研究。该研究共纳入 1254 名参与者,随访至 2010-2011 年(年龄 28-42 岁)。通过颈动脉内膜中层厚度(IMT)和肱踝脉搏波速度(PWV)分别评估颈动脉粥样硬化和主动脉僵硬度。

结果

儿童时期的 PP 和平均动脉压(MAP)均与成年颈动脉 IMT 和 PWV 独立相关,调整了性别、儿童年龄、随访时间和其他传统心血管危险因素。进一步调整了成人 PP 和 MAP 值后,儿童时期的 PP 仍与成年颈动脉 IMT 相关,但与 PWV 无关,而儿童时期的 MAP 与成年 PWV 相关,但与颈动脉 IMT 无关。此外,与在儿童期和成年期均有正常 PP 的参与者相比,无论儿童期 PP 状态如何,仅在成年期有高 PP 的参与者的颈动脉 IMT 和 PWV 水平更高(均 P<0.05)。在儿童期有高 PP 而在成年期有正常 PP 的参与者的成年颈动脉 IMT 水平也较高,但 PWV 水平与始终有正常 PP 的参与者相似。

结论

儿童时期的大 PP 对成年后亚临床血管损伤的发展起着重要作用。这些发现强调了早期预防大 PP 以降低未来心血管疾病风险的重要性。

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