Lan Yang, Liu Huan, Liu Jinbo, Zhao Hongwei, Wang Hongyu
Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China.
Int J Hypertens. 2019 Jun 25;2019:7457385. doi: 10.1155/2019/7457385. eCollection 2019.
The association of pressure load with elasticity in vascular system has not been studied fully. We proposed a hypothesis whether gender could modify the association of blood pressure variability (BPV) and arterial stiffness assessed by carotid-femoral pulse wave velocity (CF-PWV) in prehypertensive patients. 24h ambulatory blood pressure monitoring (24h-ABPM) and CF-PWV were measured in 723 participants with prehypertension. Univariate and multivariate regression analyses of these clinical and biological parameters were performed in total population, male and female. A total of 723 participants (mean age 59.76 ± 12.37years, male 329 and female 394) were enrolled into the study. Compared with female, body mass index (BMI), fasting plasma glucose (FPG), uric acid (UA), and homocysteine (HCY) were significantly higher (all p < 0.05). Arterial stiffness (CF-PWV, male versus female, 10.89 ± 2.50 versus 10.33 ± 2.13 m/s, p=0.004) and BPVs (male versus female, 24 h SBPV 13.2 ± 5.11 versus 13.03 ± 5.20; 24 h DBPV 10.34 ± 3.87 versus 9.64 ± 3.59; N SBPV 11.90 ± 6.60 versus 10.94 ± 4.79; N DBPV 9.64 ± 5.87 versus 8.20 ± 4.48, all p<0.05) were higher in male. Multivariable linear regression analysis showed that 24 h BPV were linearly and positively related to CF-PWV in total population (24h SBPV, B=0.033; 24 h DBPV, B=0.035, both P<0.05) and female (24h SBPV, B=0.041; 24h DBPV, B=0.067, both P<0.05) independent of traditional risk factors and medications. BPV was independently associated with arterial stiffness in total population and the relation was modified by gender. 24 h BPVs in prehypertensive patients were useful to identify the early arterial stiffness. . This trial was registered with Clinical Trials.gov Identifier: NCT02569268.
血管系统中压力负荷与弹性之间的关联尚未得到充分研究。我们提出了一个假设，即性别是否会改变高血压前期患者中血压变异性（BPV）与通过颈股脉搏波速度（CF-PWV）评估的动脉僵硬度之间的关联。对723名高血压前期参与者进行了24小时动态血压监测（24h-ABPM）和CF-PWV测量。对这些临床和生物学参数进行了全人群、男性和女性的单变量和多变量回归分析。共有723名参与者（平均年龄59.76±12.37岁，男性329名，女性394名）纳入研究。与女性相比，体重指数（BMI）、空腹血糖（FPG）、尿酸（UA）和同型半胱氨酸（HCY）显著更高（均p<0.05）。男性的动脉僵硬度（CF-PWV，男性与女性相比，10.89±2.50对10.33±2.13m/s，p = 0.004）和BPV（男性与女性相比，24小时收缩压变异性13.2±5.11对13.03±5.20；24小时舒张压变异性10.34±3.87对9.64±3.59；夜间收缩压变异性11.90±6.60对10.94±4.79；夜间舒张压变异性9.64±5.87对8.20±4.48，均p<0.05）更高。多变量线性回归分析表明，在全人群（24小时收缩压，B = 0.033；24小时舒张压，B = 0.035，均P<0.0）和女性（24小时收缩压，B = 0.041；24小时舒张压，B = 0.067，均P<0.05）中，24小时BPV与CF-PWV呈线性正相关，独立于传统危险因素和药物治疗。BPV在全人群中与动脉僵硬度独立相关，且这种关系受性别影响。高血压前期患者的夜间BPV有助于识别早期动脉僵硬度。本试验已在ClinicalTrials.gov注册，标识符：NCT02569268。
