Lakatta Edward G, AlunniFegatelli Danilo, Morrell Christopher H, Fiorillo Edoardo, Orru Marco, Delitala Alessandro, Marongiu Michele, Schlessinger David, Cucca Francesco, Scuteri Angelo
Laboratory of Cardiovascular Sciences, National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD.
Department of Public Health and Infectious Disease, University "La Sapienza", Rome, Italy.
J Am Med Dir Assoc. 2020 Jun;21(6):720-725. doi: 10.1016/j.jamda.2019.11.014. Epub 2019 Dec 26.
Carotid-femoral pulse wave velocity (PWV), an index of arterial stiffness and a proxy of arterial aging, has been reported to be an independent determinant of cardiovascular health. Whether the effects of antihypertensive treatment vary in the presence of accelerated arterial aging (stiffer artery, ie, PWV >10 m/s) has not been established. We tested this hypothesis in a longitudinal study in a large community-dwelling population.
Longitudinal population study with repeated measures.
Study population consisted of a cohort of 6011 volunteers (2546 men and 3465 women, age range 14-101 years; 15,011 observations over a median follow-up of 6.8 years) participating in the SardiNIA Study.
Repeated measures of PWV, blood pressure (BP), and metabolic risk factors and the antihypertensive medication trajectories of BP and PWV over time were assessed via mixed effects models.
Antihypertensive treatment significantly affected the trajectory of BP in both participants with (-0.47 ± 0.20 mmHg/y, P = .02) and participants without stiffer arteries (-0.47 ± 0.07 mmHg/y, P = .001). They also affected the trajectory of PWV in participants with stiffer artery, independent of the BP values.
Antihypertensive treatment is effective in reducing both BP and PWV in older individuals with stiffer arteries.
颈动脉-股动脉脉搏波速度（PWV）是动脉僵硬度的指标及动脉衰老的替代指标，据报道是心血管健康的独立决定因素。在存在动脉加速衰老（动脉更僵硬，即PWV>10 m/s）的情况下，降压治疗的效果是否不同尚未明确。我们在一项针对大型社区居住人群的纵向研究中检验了这一假设。
重复测量的纵向人群研究。
研究人群包括6011名志愿者队列（2546名男性和3465名女性，年龄范围14 - 101岁；在中位随访6.8年期间进行了15011次观察），他们参与了撒丁岛研究。
通过混合效应模型评估PWV、血压（BP）和代谢危险因素的重复测量值，以及随时间变化的BP和PWV的降压药物治疗轨迹。
降压治疗对动脉较僵硬的参与者（-0.47±0.20 mmHg/年，P = 0.02）和动脉不僵硬的参与者（-0.47±0.07 mmHg/年，P = 0.001）的BP轨迹均有显著影响。它们还独立于BP值影响了动脉较僵硬参与者的PWV轨迹。
降压治疗对动脉较僵硬的老年人降低BP和PWV均有效。
