Paris-Descartes University.
Hypertension and Cardiovascular Prevention Unit, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital.
J Hypertens. 2018 Dec;36(12):2324-2332. doi: 10.1097/HJH.0000000000001828.
Aortic stiffness may provide information to classical risk factors information regarding cardiovascular risk. Aortic pulse wave velocity (PWV) can be measured by applanation tonometry but also theoretical PWV was calculated according to age, blood pressure, heart rate and sex. We aim to highlight biological and hemodynamic determinants of the aortic PWV index, that is the individually calculated [(measured PWV - theoretical PWV)/theoretical PWV] difference, in hypertensive diabetic patients.
A cross-sectional study was conducted in 514 patients, involving normotensive and hypertensive patients and people with and without diabetes. Biological parameters were measured during day-hospital for cardiovascular screening. Hemodynamic parameters were determined by applanation tonometry. Multivariate regression analyses evaluated the PWV index determinants.
Hypertensive and/or diabetic population presents higher PWV index in correlation with the presence of proteinuria (P = 0.0428) and previous cardiovascular events (P = 0.0227). Hypertensive diabetic patients present a higher PWV index than the other patients (P < 0.05). Presence of insulin therapy (P = 0.0101) and the type 1 diabetes (P = 0.0065) were positively and independently modulating PWV index in hypertensive diabetic patients. HDL cholesterol levels (P = 0.0245) and absence of carotid (P = 0.0468) plaques were independently modulating PWV index with a negative correlation in hypertensive without diabetes patients. C reactive protein levels were significantly associated with increased PWV index in hypertensive patients (P = 0.0074) and in hypertensive and/or diabetic population (P = 0.0184).
PWV index was correlated with numerous cardiovascular risk factors, in addition of being a marker of age and hypertension. Therefore, this index appears as a cardiovascular risk integrator. Its use could be interesting in cardiovascular risk assessment and reduction strategies.
主动脉僵硬度可以提供有关心血管风险的信息，补充经典风险因素。脉搏波速度（PWV）可以通过平板压力测量法进行测量，也可以根据年龄、血压、心率和性别计算理论 PWV。我们旨在强调高血压糖尿病患者主动脉 PWV 指数（即个体计算的（实测 PWV-理论 PWV）/理论 PWV 的差异）的生物学和血液动力学决定因素。
横断面研究纳入了 514 名患者，包括正常血压和高血压患者以及有或没有糖尿病的患者。在心血管筛查的日间住院期间测量了生物学参数。应用平板压力测量法测定血液动力学参数。多元回归分析评估了 PWV 指数的决定因素。
高血压和/或糖尿病患者的 PWV 指数与蛋白尿（P=0.0428）和既往心血管事件（P=0.0227）的存在呈正相关。与其他患者相比，高血压糖尿病患者的 PWV 指数更高（P<0.05）。胰岛素治疗（P=0.0101）和 1 型糖尿病（P=0.0065）的存在是高血压糖尿病患者 PWV 指数的正向独立调节因素。HDL 胆固醇水平（P=0.0245）和无颈动脉斑块（P=0.0468）与高血压无糖尿病患者的 PWV 指数呈负相关，独立调节 PWV 指数。C 反应蛋白水平与高血压患者（P=0.0074）和高血压及/或糖尿病患者（P=0.0184）的 PWV 指数显著相关。
PWV 指数与许多心血管危险因素相关，除了是年龄和高血压的标志物外。因此，该指数可作为心血管风险综合指标。它的使用可能有助于评估和降低心血管风险。
