Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China; Department of Life Science and Medicine, King's College London, London, United Kingdom.
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
J Am Coll Cardiol. 2020 Mar 3;75(8):870-880. doi: 10.1016/j.jacc.2019.12.039.
Arterial stiffening is central in the vascular aging process. Traditionally, vascular research has focused on atherosclerotic vascular disease, whereas arterial stiffness has not attracted similar attention.
The purpose of this study was to assess lifetime trajectories of arterial stiffening in Chinese populations facing a high burden of cardiovascular disease, with a particular focus on age-sex interactions and potential determinants.
This large-scale observational study comprised 2 independent cross-sectional population samples and 1 prospective cohort totaling 80,415 healthy subjects with brachial-ankle pulse wave velocity (baPWV) measurements available. Associations with potential risk conditions were analyzed using linear regression, linear random intercepts mixed models, and L1-regularized linear models.
The dynamics of age-dependent arterial stiffening differed in sexes, with stiffer vessel observed in men from adolescence to age 58 years and in women thereafter. The steeper increase in baPWV in women after menopause is partly explained by the fact that vascular risk factors are more strongly associated with arterial stiffness in women than in men. Age and systolic blood pressures were the strongest determinants of baPWV, whereas other vascular and metabolic risk factors, except low-density lipoprotein cholesterol, showed consistent associations of moderate strength.
The significant age-sex interaction in arterial stiffening provides an important clue of explanation for the heightened cardiovascular disease risk in postmenopausal women. Detailed knowledge on lifetime trajectories of arterial stiffening, and its potential risk factors is a prerequisite for the development of new prevention strategies counteracting vascular aging.
动脉僵硬度是血管老化过程的核心。传统上，血管研究主要集中在动脉粥样硬化性血管疾病上，而动脉僵硬度并没有引起类似的关注。
本研究旨在评估面临心血管疾病负担高的中国人群中动脉僵硬度的终生轨迹，特别关注年龄性别相互作用和潜在决定因素。
这项大规模观察性研究包括 2 个独立的横断面人群样本和 1 个前瞻性队列，共纳入 80415 名有肱踝脉搏波速度（baPWV）测量值的健康受试者。使用线性回归、线性随机截距混合模型和 L1 正则化线性模型分析与潜在风险条件的关联。
年龄相关动脉僵硬度的动态在性别上有所不同，男性从青春期到 58 岁血管较硬，而女性此后则较硬。绝经后女性的 baPWV 增加更为陡峭，部分原因是血管危险因素与女性动脉僵硬度的相关性强于男性。年龄和收缩压是 baPWV 的最强决定因素，而其他血管和代谢危险因素（除了低密度脂蛋白胆固醇）则表现出一致的中等强度关联。
动脉僵硬度的显著年龄性别相互作用为绝经后女性心血管疾病风险增加提供了重要的解释线索。详细了解动脉僵硬度的终生轨迹及其潜在的危险因素是制定新的预防策略以对抗血管老化的前提。
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