Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan.
Hypertens Res. 2020 Nov;43(11):1301-1308. doi: 10.1038/s41440-020-0493-2. Epub 2020 Jun 18.
Although elevated blood pressure results in arterial stiffening, the converse could also be true. Previous studies have suggested that increased arterial stiffness precedes the development of hypertension. Since central blood pressure is augmented following arterial stiffening, the predictive value of central blood pressure for detecting new-onset hypertension was investigated in the general population. A total of 7840 normotensive subjects (male, 4592; mean age, 51 years) were followed up for a median of 4 years, with the endpoint being the development of hypertension. During the actual follow-up period of 31636 person-years, hypertension developed in 2608 subjects. Kaplan-Meier analysis revealed an increase in the risk of hypertension across the quartiles of baseline central blood pressure (log-rank P < 0.001), with incidence rates of hypertension in the first, second, third, and fourth quartiles of 8.8%, 22.3%, 39.9%, and 63.2%, respectively. Multivariate Cox hazard analysis demonstrated an increased hazard ratio of incident hypertension across the quartiles after adjustment for possible factors. Repeating the multivariate Cox hazard analysis with central blood pressure as a continuous variable also identified central blood pressure at baseline as a significant predictor of new-onset hypertension (P < 0.001). These results suggest that central blood pressure is a significant predictor of new-onset hypertension in individuals without hypertension.
虽然高血压会导致动脉僵硬，但反之亦然。先前的研究表明，动脉僵硬先于高血压的发展。由于中心血压在动脉僵硬后增加，因此研究人员在普通人群中调查了中心血压对检测新发高血压的预测价值。共有 7840 名血压正常的受试者（男性 4592 名；平均年龄 51 岁）接受了中位数为 4 年的随访，终点为高血压的发生。在实际的 31636 人年随访期间，2608 名受试者发生了高血压。Kaplan-Meier 分析显示，随着基线中心血压四分位的升高，高血压的风险呈上升趋势（对数秩 P<0.001），第一、二、三、四分位的高血压发生率分别为 8.8%、22.3%、39.9%和 63.2%。多变量 Cox 风险分析表明，在调整可能的因素后，各四分位的高血压发生风险比均增加。用中心血压作为连续变量重复多变量 Cox 风险分析也表明，基线时的中心血压是新发高血压的一个显著预测因素（P<0.001）。这些结果表明，中心血压是无高血压个体新发高血压的一个重要预测因素。
