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四臂血压差异与老年中国人心血管危险因素和靶器官变化的关联:上海北部研究。

The association of four-limb blood pressure differences with cardiovascular risk factors and target organ changes in elderly Chinese: The Northern Shanghai Study.

机构信息

Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, Paris Descartes University, Paris, France.

出版信息

Clin Exp Hypertens. 2020;42(3):275-280. doi: 10.1080/10641963.2019.1649682. Epub 2019 Aug 5.

DOI:10.1080/10641963.2019.1649682
PMID:31378094
Abstract

: The association of four-limb systolic blood pressure differences (SBPDs) including inter-arm (IASBPD), inter-leg (ILSBPD) and ankle-brachial index (ABI) with cardiovascular risk factors and target organ changes (TOCs) remains controversial. This study aims at investigating the association of those parameters with cardiovascular risk factors and TOCs in an elderly Chinese population.: A total of 1528 subjects derived from the Northern Shanghai Study were studied. Four-limb BPs were simultaneously measured by VP-1000 device. Cardiovascular risk factors and TOCs including parameters of left ventricular structure and function, carotid intima-media thickness, carotid-femoral pulse-wave velocity (CF-PWV), estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio, were evaluated with standardized methods.: ABI significantly associated age (β = -0.004, < .01), female gender (β = 0.02, < .01), body mass index (β = -0.004, < .01), smoking (β = -0.04, < .01), high-density lipoprotein (β = 0.04, < .01), low-density lipoprotein (β = -0.01, = .01) and diabetes mellitus (β = -0.02, < .01), while the fourth root of IASBPD significantly associated with body mass index (β = 0.03, < .01), high-density lipoprotein (β = -0.10, = .02) and brachial SBP (β = 0.003, < .01); the fourth root of ILSBPD significantly associated with high-density lipoprotein (β = -0.12, < .01) and diabetes mellitus (β = 0.09, = .01). IASBPD, ILSBPD, and ABI all significantly associated with CF-PWV and eGFR (all < .05) in either unadjusted or adjusted models, but not with other TOCs.: Four-limb SBPDs, namely ABI, IASBPD, and ILSBPD, bore various burdens of cardiovascular risk factors and significantly and independently associated with CF-PWV and eGFR.

摘要

四臂收缩压差值(SBPD)包括臂间(IASBPD)、腿间(ILSBPD)和踝肱指数(ABI)与心血管危险因素和靶器官变化(TOCs)的关联仍存在争议。本研究旨在调查老年人群中这些参数与心血管危险因素和 TOCs 的相关性。

共有 1528 名来自上海北部研究的受试者参与了研究。使用 VP-1000 设备同时测量四肢血压。采用标准化方法评估心血管危险因素和 TOCs,包括左心室结构和功能参数、颈动脉内膜中层厚度、颈动脉-股动脉脉搏波速度(CF-PWV)、估算肾小球滤过率(eGFR)和尿白蛋白/肌酐比值。

ABI 与年龄(β=-0.004, <.01)、女性性别(β=0.02, <.01)、体重指数(β=-0.004, <.01)、吸烟(β=-0.04, <.01)、高密度脂蛋白(β=0.04, <.01)、低密度脂蛋白(β=-0.01, =.01)和糖尿病(β=-0.02, <.01)显著相关,而 IASBPD 的四次方根与体重指数(β=0.03, <.01)、高密度脂蛋白(β=-0.10, =.02)和肱动脉 SBP(β=0.003, <.01)显著相关;ILSBPD 的四次方根与高密度脂蛋白(β=-0.12, <.01)和糖尿病(β=0.09, =.01)显著相关。在未调整和调整模型中,IASBPD、ILSBPD 和 ABI 均与 CF-PWV 和 eGFR 显著相关(均 <.05),但与其他 TOCs 无关。

四肢 SBPD,即 ABI、IASBPD 和 ILSBPD,与心血管危险因素有不同的负担,并与 CF-PWV 和 eGFR 显著且独立相关。

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