Emergency Department, Xiyuan Hospital, China Academy of Chines Medical Sciences, Xi Yuan Cao Chang No. 1, Beijing, China.
Blood Press Monit. 2020 Dec;25(6):310-317. doi: 10.1097/MBP.0000000000000471.
Previous researches demonstrate that mean arterial pressure (MAP) is associated with major cardiovascular events, but there are few research on the correlation between MAP and brachial-ankle pulse wave velocity (BaPWV). Thus, the present study is designated to examine the association between MAP and BaPWV. Our study is a cross-sectional study in Japanese. They participated in a medical check-up program which included BaPWV and standardized questionnaires. The main measurements include systolic blood pressure, diastolic blood pressure, BaPWV, ankle-brachial index (ABI), fatty liver diagnosed by ultrasonography, etc. It needs to be emphasized that Fukuda et al. finished the study and their data are used for secondary analysis. MAP is positively related with BaPWV [effect size = 10.4; 95% confidence interval (CI), 9.2-11.6] after adjusting age, sex, BMI, smoking status, alcohol consumption, exercise, glutamyltranspeptidase, alanine aminotransferase, aspartate transaminase, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein cholesterol (HDL), fatty liver, fasting-blood glucose, uric acid, estimated glomerular filtration rate, and ABI. The nonlinear association is identified between MAP and BaPWV whose inflection point is 94 mmHg. The effect size and 95% CI on the bilateral sides of the inflection point are 8.0 (4.4-11.6) and 14.8 (12.5-17.1), respectively. Subgroup analysis indicates that MAP has a more significantly positive association with BaPWV in ex-smokers, old people (age ≥60), and participants with lower HDL (<40 mg/dL). Consequently, it is practicable for us to roughly predict BaPWV with simple MAP measurement instead of the BaPWV examination.
先前的研究表明,平均动脉压(MAP)与主要心血管事件相关,但关于 MAP 与臂踝脉搏波速度(BaPWV)之间的相关性的研究较少。因此,本研究旨在探讨 MAP 与 BaPWV 之间的关系。
我们的研究是一项在日本人中进行的横断面研究。他们参加了一项包括 BaPWV 和标准化问卷在内的体检计划。主要测量指标包括收缩压、舒张压、BaPWV、踝臂指数(ABI)、超声诊断的脂肪肝等。需要强调的是,Fukuda 等人完成了这项研究,并对其数据进行了二次分析。
在校正年龄、性别、BMI、吸烟状况、饮酒、运动、谷氨酰转肽酶、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白胆固醇(HDL)、脂肪肝、空腹血糖、尿酸、估算肾小球滤过率和 ABI 后,MAP 与 BaPWV 呈正相关[效应量=10.4;95%置信区间(CI)为 9.2-11.6]。MAP 与 BaPWV 之间存在非线性关系,拐点为 94mmHg。拐点两侧的效应量和 95%CI 分别为 8.0(4.4-11.6)和 14.8(12.5-17.1)。亚组分析表明,MAP 与 BaPWV 在戒烟者、老年人(年龄≥60 岁)和 HDL 较低(<40mg/dL)的参与者中呈更显著的正相关。
因此,我们可以通过简单的 MAP 测量来大致预测 BaPWV,而无需进行 BaPWV 检查。