Qi Zhen, Zhao Zhi-Yue, Xu Jia-Tuo, Zhu Li-Ping, Zhang Yu, Bao Yi-Min, Zhang Zhi-Feng
Shanghai Geriatric Institute of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 365 South Xiangyang Road, Shanghai 200031, China.
Basic Medical College, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai 201203, China.
Evid Based Complement Alternat Med. 2020 Apr 29;2020:3926851. doi: 10.1155/2020/3926851. eCollection 2020.
Our aim was to study whether radial pulse wave signals can improve the risk prediction of incident hypertension and are associated with its concomitant metabolic risk factors beyond the traditional cardiovascular risk factor Ba-PWV. By enrolling 523 Chinese subjects in this study, linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave signals and Ba-PWV with blood pressure and its related metabolic risk factors such as fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and uric acid (UA). The area under the receiver-operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated by risk assessment plot to compare the discriminative ability among models with and without radial artery pulse wave signals. After adjusting related confounding factors, radial artery pulse wave variable / was selected as the sensitive influential factor for blood pressure. Moreover, a new model with / had a higher AUC than the reference model without it (0.86 vs 0.84; =0.030). And the NRI and IDI for the new model was 50.0% (=0.017) and 3.16% (=0.044), respectively. In addition to Ba-PWV, we found that the decrease of , , and might be associated with higher FPG, TC, LDL-C, and UA and lower HDL-C. This research might provide a valuable additional tool for remote wearable monitoring of radial artery pulse wave signals in hypertension risk evaluation and management.
我们的目的是研究桡动脉脉搏波信号是否能改善对新发高血压的风险预测，以及除传统心血管危险因素臂踝脉搏波速度（Ba-PWV）外，是否与高血压伴发的代谢危险因素相关。通过招募523名中国受试者参与本研究，进行线性和逐步回归分析，以评估桡动脉脉搏波信号和Ba-PWV与血压及其相关代谢危险因素（如空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和尿酸（UA））之间的关联。通过风险评估图计算受试者工作特征曲线下面积（AUC）、净重新分类改善（NRI）和综合判别改善（IDI），以比较有无桡动脉脉搏波信号的模型之间的判别能力。在调整相关混杂因素后，选择桡动脉脉搏波变量/作为血压的敏感影响因素。此外，包含/的新模型的AUC高于不包含该变量的参考模型（0.86对0.84；P = 0.030）。新模型的NRI和IDI分别为50.0%（P = 0.017）和3.16%（P = 0.044）。除了Ba-PWV，我们发现， 、 和 的降低可能与较高的FPG、TC、LDL-C和UA以及较低的HDL-C有关。本研究可能为高血压风险评估和管理中远程可穿戴监测桡动脉脉搏波信号提供一个有价值的额外工具。
