血管老化及其与一般西班牙人群生活方式和其他风险因素的关系：早期血管老化研究。

Vascular aging and its relationship with lifestyles and other risk factors in the general Spanish population: Early Vascular Ageing Study.

机构信息

Biomedical Research Institute of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla and Leon (SACyL), Salamanca.

Department of Statistics, University of Salamanca, Salamanca, Spain.

出版信息

J Hypertens. 2020 Jun;38(6):1110-1122. doi: 10.1097/HJH.0000000000002373.

DOI:10.1097/HJH.0000000000002373

PMID:32371801

Abstract

OBJECTIVES

To describe the prevalence of healthy vascular aging (HVA), normal vascular aging and early vascular aging (EVA) in a sample of Spanish population without cardiovascular disease. The relationship of vascular aging with lifestyle, cardiovascular risk factors, psychological and inflammatory risk factors is also analyzed.

METHODS

A total of 501 participants were recruited (49.70% men, aged 55.90 ± 14.24 years) by random sampling. Vascular aging was defined in three steps: Step 1: participants with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: with the percentiles of carotid-to-femoral pulse wave velocity (cfPWV) we used three criteria, first, the 10th and 90th cfPWV percentiles of the population studied by age and sex; second, the 10th and 90th percentiles of the European population reference values and third, the 25th and 75th cfPWV percentiles of the population studied by age and sex. Step 3: participants with hypertension or type 2 diabetes mellitus included in HVA were reclassified as normal vascular aging. Arterial stiffness was assessed with cfPWV using a Sphygmocor device. Physical activity was measured with an accelerometer. Psychological factors, lifestyle and other clinical information were obtained by standard questionnaire.

RESULTS

The global prevalence of HVA was 8 and 14% (men 8 and 10%, women 9 and 18%), and 22 and 18% (men 26 and 23%, women 17 and 12%) for EVA, using criteria a and b, respectively. In the logistic regression analysis, vascular aging maintains positive associations with more sedentary time [odds ratio (OR) = 2.37 and 4.51], having triglycerides above 150 mg/dl (OR = 6.55 and 4.06), abdominal obesity (OR = 2.73 and 2.90), increased uric acid (OR = 4.63 and 2.98) and insulin resistance index homeostatic model assessment (OR = 4.05 and 6.78), and a negative association with less physical activity (OR = 0.29 and 0.28) using criteria a and b, respectively.

CONCLUSION

One in 10 has HVA and one in five EVA. The prevalence of EVA is higher in men. Study results suggest that preventive strategies aimed at increasing physical activity, reducing sedentary time and decreasing obesity and insulin resistance improve vascular aging.

摘要

目的

描述西班牙无心血管疾病人群中健康血管老化（HVA）、正常血管老化和早期血管老化（EVA）的流行情况。还分析了血管老化与生活方式、心血管危险因素、心理和炎症危险因素的关系。

方法

通过随机抽样，共招募了 501 名参与者（49.70%为男性，年龄 55.90±14.24 岁）。血管老化分三步定义：步骤 1：颈动脉或外周动脉疾病存在血管损伤的参与者被归类为 EVA。步骤 2：根据颈动脉-股动脉脉搏波速度（cfPWV）的百分位数，我们使用了三个标准，首先是按年龄和性别研究人群的 10 至 90 百分位 cfPWV；其次是欧洲人群参考值的 10 至 90 百分位；最后是按年龄和性别研究人群的 25 至 75 百分位 cfPWV。步骤 3：将高血压或 2 型糖尿病患者纳入 HVA 再重新归类为正常血管老化。使用 Sphygmocor 设备测量 cfPWV 评估动脉僵硬度。使用加速度计测量体力活动。通过标准问卷获得心理因素、生活方式和其他临床信息。

结果

使用标准 a 和 b，HVA 的全球患病率分别为 8%和 14%（男性 8%和 10%，女性 9%和 18%），EVA 分别为 22%和 18%（男性 26%和 23%，女性 17%和 12%）。在逻辑回归分析中，血管老化与久坐时间增加（优势比[OR] = 2.37 和 4.51）、三酰甘油水平超过 150mg/dl（OR = 6.55 和 4.06）、腹部肥胖（OR = 2.73 和 2.90）、尿酸升高（OR = 4.63 和 2.98）和胰岛素抵抗指数稳态模型评估（OR = 4.05 和 6.78）呈正相关，与体力活动减少（OR = 0.29 和 0.28）呈负相关，分别使用标准 a 和 b。