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中国高血压患者血脂谱与动脉僵硬度的关联:来自CSPPT的见解

Association Between Lipid Profiles and Arterial Stiffness in Chinese Patients With Hypertension: Insights From the CSPPT.

作者信息

Zhan Biming, Huang Xiao, Wang Jiancheng, Qin Xianhui, Zhang Jingping, Cao Jingjing, Song Yun, Liu Lishun, Li Ping, Yang Renqiang, Wu Yanqing, Wu Qinghua, Zhang Yan, Li Jianping, Huo Yong, Wang Binyan, Xu Xiping, Bao Huihui, Cheng Xiaoshu

机构信息

1 Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang Shi, Jiangxi, China.

2 Renal Division, Nanfang Hospital, National Clinical Research Study Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, China.

出版信息

Angiology. 2019 Jul;70(6):515-522. doi: 10.1177/0003319718823341. Epub 2019 Jan 16.

DOI:10.1177/0003319718823341
PMID:30651004
Abstract

Arterial stiffness plays a key role in the pathogenesis of cardiovascular disease. However, the relationship between lipid levels and arterial stiffness is controversial. We aimed to investigate the association between lipid parameters and brachial-ankle pulse-wave velocity (baPWV) in Chinese patients with hypertension. A total of 14 071 participants with hypertension in the China Stroke Primary Prevention Trial (CSPPT) were enrolled in the present study. Patients were assigned to 4 equal groups according to their baPWV. Participants in the highest baPWV group were older with a higher prevalence of stroke and diabetes mellitus as well as higher body mass index (BMI), blood pressure, fasting plasma glucose, uric acid, total cholesterol (TC), triglycerides (TG), homocysteine (Hcy), and vitamin B12 levels ( P < .001). After adjusting for age, sex, BMI, and other cardiovascular risks, high-density lipoprotein cholesterol (HDL-C) was negatively related to baPWV (β = -0.22, P = .012), TC (β = 0.08, P = 0.001), TG (β = 0.14, P = .001); non-HDL-C (β = 0.12, P = .001) and positively related to baPWV. The effect was not observed for low-density lipoprotein cholesterol (LDL-C; β = 0.12, P = .335).These results suggested that non-HDL-C, TG, and TC were associated with arterial stiffness in a Chinese population with hypertension. HDL-C was inversely associated with arterial stiffness.

摘要

动脉僵硬度在心血管疾病的发病机制中起关键作用。然而,血脂水平与动脉僵硬度之间的关系存在争议。我们旨在研究中国高血压患者血脂参数与臂踝脉搏波速度(baPWV)之间的关联。中国卒中一级预防试验(CSPPT)中共有14071名高血压参与者纳入本研究。根据baPWV将患者分为4个相等的组。baPWV最高组的参与者年龄较大,中风和糖尿病患病率较高,以及体重指数(BMI)、血压、空腹血糖、尿酸、总胆固醇(TC)、甘油三酯(TG)、同型半胱氨酸(Hcy)和维生素B12水平较高(P <.001)。在调整年龄、性别、BMI和其他心血管风险后,高密度脂蛋白胆固醇(HDL-C)与baPWV呈负相关(β = -0.22,P =.012),与TC(β = 0.08,P = 0.001)、TG(β = 0.14,P =.001)、非HDL-C(β = 0.12,P =.001)呈正相关,与baPWV呈正相关。低密度脂蛋白胆固醇(LDL-C;β = 0.12,P =.335)未观察到这种效应。这些结果表明,在中国高血压人群中,非HDL-C、TG和TC与动脉僵硬度相关。HDL-C与动脉僵硬度呈负相关。

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