Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Prevention & Rehabilitation Center, Heart Vascular & Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea.
Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Clin Exp Hypertens. 2019;41(8):733-738. doi: 10.1080/10641963.2018.1545849. Epub 2018 Nov 30.
There is a well-established relationship between cardiorespiratory fitness (CRF) and arterial stiffness. However, it is unclear whether this relationship differs significantly between hypertensive and non-hypertensive patients. Adults without a history of ischemic heart disease or stroke and normal exercise test results who underwent health screening were included. Cardiopulmonary function test was performed using the Bruce protocol. Peak oxygen consumption (VO2peak) was measured. Arterial stiffness was evaluated using the brachial-ankle pulse wave velocity (baPWV). Study subjects were 9232 participants (M:F = 71:29%) with a mean age of 53 ± 6 years. Thirty-four percent had hypertension. There was an inverse relationship between the peak oxygen consumption and baPWV (r = - 0.21, p < 0.001) This relationship persisted after adjusting for age, gender, body mass index, smoking, diabetes mellitus, hemoglobin A1c, LDL-cholesterol, mean blood pressure, and hypertension (p < 0.0001). The regression coefficient of VO2peak was significantly more negative among hypertensive subjects than it was in non-hypertensive subjects in the regression coefficient (-9.2 vs. -4.2, p for interaction <0.001). The difference in arterial stiffness between hypertensive and non-hypertensive groups decreased as the CRF increased. Arterial stiffness decreased as CRF increased among participants without overt cardiovascular disease. The effect of hypertension on arterial stiffness also decreased as the CRF increased.
心肺适能（CRF）与动脉僵硬之间存在着明确的关系。然而，尚不清楚这种关系在高血压和非高血压患者之间是否存在显著差异。本研究纳入了无缺血性心脏病或中风病史且运动试验结果正常的成年人，进行健康筛查。采用 Bruce 方案进行心肺功能测试，测量峰值耗氧量（VO2peak）。采用肱踝脉搏波速度（baPWV）评估动脉僵硬程度。研究对象为 9232 名参与者（M：F = 71：29%），平均年龄为 53 ± 6 岁，34%患有高血压。峰值耗氧量与 baPWV 呈负相关（r = - 0.21，p < 0.001），这种关系在调整年龄、性别、体重指数、吸烟、糖尿病、糖化血红蛋白、LDL 胆固醇、平均血压和高血压后仍然存在（p < 0.0001）。在回归系数中，高血压患者的 VO2peak 回归系数明显低于非高血压患者（-9.2 比-4.2，p 交互<0.001）。随着 CRF 的增加，高血压组和非高血压组之间的动脉僵硬差异减小。在无明显心血管疾病的参与者中，随着 CRF 的增加，动脉僵硬程度降低。随着 CRF 的增加，高血压对动脉僵硬的影响也降低。
