From the Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook School of Medicine, NY (J.E.S.).
Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY (J.E.S.).
Hypertension. 2019 Jul;74(1):111-116. doi: 10.1161/HYPERTENSIONAHA.119.12756. Epub 2019 May 28.
Pulse wave velocity (PWV), a measure of arterial stiffness, is an independent risk factor for cardiovascular morbidity and mortality. We investigated the relationship of ambulatory brachial cuff-based oscillometric PWV (oPWV) to 2 known correlates: age and brachial systolic blood pressure (SBP). In 234 participants in the Masked Hypertension Study, we analyzed 7284 validated hourly ambulatory SBP and oPWV readings using the Mobil-O-Graph monitor, which uses a proprietary pulse wave analysis algorithm to determine oPWV. Carotid-femoral PWV (cfPWV) was also measured. Mixed linear models were developed to estimate oPWV from age and ambulatory SBP. Participants were 34% male, with mean (SD) age 52.8 (9.9) years, SBP 123.8 (18.4) mm Hg, and oPWV 7.6 (1.3) m/s and cfPWV of 7.7 (1.7) m/s. The relationship of oPWV to age and SBP is given below: [Formula: see text] Age uniquely accounted for an estimated 75% of the total variation of oPWV, whereas SBP uniquely accounted for 20%; these findings were confirmed in an external validation dataset. Together, age and SBP accounted for 99.1% of the total variance of oPWV but (only) 40.2% of the variance of cfPWV. The correlation between oPWV and cfPWV was 0.58 but was only 0.11 after controlling for age and SBP. We conclude that the Mobil-O-Graph's oPWV is nearly completely explained by age and SBP and its relationship to cfPWV is because of their shared associations with age and SBP. Other hemodynamic variables derived from oscillometric pulse wave analysis may be useful and deserve additional scrutiny.
脉搏波速度(PWV)是动脉僵硬度的一种衡量标准,是心血管发病率和死亡率的独立危险因素。我们研究了基于动态臂带的示波法脉搏波速度(oPWV)与 2 个已知相关因素:年龄和肱动脉收缩压(SBP)的关系。在掩蔽性高血压研究的 234 名参与者中,我们使用 Mobil-O-Graph 监测仪分析了 7284 次经过验证的每小时动态 SBP 和 oPWV 读数,该监测仪使用专有的脉搏波分析算法来确定 oPWV。还测量了颈股脉搏波速度(cfPWV)。建立了混合线性模型,以便根据年龄和动态 SBP 估算 oPWV。参与者中男性占 34%,平均(SD)年龄为 52.8(9.9)岁,SBP 为 123.8(18.4)mmHg,oPWV 为 7.6(1.3)m/s,cfPWV 为 7.7(1.7)m/s。oPWV 与年龄和 SBP 的关系如下:[公式:见正文] 年龄单独解释了 oPWV 总变异的约 75%,而 SBP 单独解释了 20%;这些发现在外验证数据集得到了证实。年龄和 SBP 共同解释了 oPWV 总方差的 99.1%,但仅解释了 cfPWV 方差的 40.2%。oPWV 与 cfPWV 的相关性为 0.58,但在控制年龄和 SBP 后仅为 0.11。我们得出结论,Mobil-O-Graph 的 oPWV 几乎完全由年龄和 SBP 解释,它与 cfPWV 的关系是由于它们与年龄和 SBP 具有共同的关联。其他源自示波法脉搏波分析的血流动力学变量可能有用,值得进一步研究。