Ikemiyagi Hidekazu, Ishida Akio, Kinjo Kozen, Ohya Yusuke
Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus.
Okinawa Health Promotion Foundation, Okinawa, Japan.
J Hypertens. 2020 Nov;38(11):2185-2191. doi: 10.1097/HJH.0000000000002540.
We aimed to determine if the ankle--brachial index (ABI) increased with age as a result of increased arterial stiffness and wave reflection, and whether this was associated with left ventricular hypertrophy (LVH).
An observational cross-sectional study was conducted in 13 396 participants aged 19-89 years who attended a health check-up. Brachial and ankle blood pressures were measured by an automatic oscillometric method. Electrocardiography-determined LVH (ECG-LVH) was defined by computer-interpreted Minnesota codes using resting 12-leads ECG.
The mean age of the participants was 53 years (54% women). The prevalence of ECG-LVH was 13%; this was the lowest in participants with normal blood pressure and increased with an increase in the hypertension grade. The ABI was higher in participants with ECG-LVH than in those without (1.13± 0.07 vs. 1.15 ± 0.07, P < 0.001). The prevalence of ECG-LVH was the highest in participants with the highest quartile of ABI (16%), followed by those with the third quartile (14%), second quartile (12%), and the lowest quartile of ABI (9%). The odds ratio for ECG-LVH was significantly higher for participants with a higher quartile of ABI than those with the lowest, before and after adjustment for several covariates. Similar results were observed in sensitivity analysis of individuals with normal kidney function, younger than 65 years, and without diabetes mellitus, performed in order to reduce the influence of a medial arterial calcification-mediated increase in ABI.
High ABI is a possible marker of arterial stiffness and/or wave reflection that, even in the normal range, is associated with ECG-LVH.
我们旨在确定踝臂指数（ABI）是否因动脉僵硬度增加和波反射而随年龄增加，以及这是否与左心室肥厚（LVH）相关。
对13396名年龄在19 - 89岁参加健康体检的参与者进行了一项观察性横断面研究。采用自动示波法测量肱动脉和踝部血压。通过计算机解读的明尼苏达编码，利用静息12导联心电图确定心电图左心室肥厚（ECG - LVH）。
参与者的平均年龄为53岁（女性占54%）。ECG - LVH的患病率为13%；在血压正常的参与者中最低，并随高血压分级增加而升高。有ECG - LVH的参与者的ABI高于无ECG - LVH的参与者（1.13±0.07对1.15±0.07，P<0.001）。ECG - LVH的患病率在ABI最高四分位数的参与者中最高（16%），其次是第三四分位数的参与者（14%）、第二四分位数的参与者（12%）和ABI最低四分位数的参与者（9%）。在对多个协变量进行调整前后，ABI较高四分位数的参与者发生ECG - LVH的比值比显著高于最低四分位数的参与者。为减少动脉中层钙化介导的ABI升高的影响，对肾功能正常、年龄小于65岁且无糖尿病的个体进行敏感性分析，观察到了类似结果。
高ABI可能是动脉僵硬度和/或波反射的一个标志物，即使在正常范围内，也与ECG - LVH相关。
