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非裔美国人血浆脂联素与血压进展:杰克逊心脏研究

Plasma Adiponectin and Blood Pressure Progression in African Americans: The Jackson Heart Study.

作者信息

Kaze Arnaud D, Musani Solomon K, Bidulescu Aurelian, Correa Adolfo, Golden Sherita H, Bertoni Alain G, Echouffo-Tcheugui Justin B

机构信息

Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA.

Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.

出版信息

Am J Hypertens. 2021 Nov 20;34(11):1163-1170. doi: 10.1093/ajh/hpab101.

Abstract

BACKGROUND

Little is known on the association of plasma adiponectin with blood pressure (BP) changes in African Americans (AAs). We evaluated the associations between plasma adiponectin and BP progression among AAs.

METHODS

We analyzed data from 1,184 participants without hypertension at baseline (2000-2004) with ≥1 follow-up visits in the Jackson Heart Study. We used robust Poisson regression to generate risk ratios (RRs) for BP progression (an increase by ≥1 BP stage) and incident hypertension.

RESULTS

Over a median of 7 years, 71% progressed to higher BP stage and 65% developed hypertension. We found evidence of interaction by sex (P-interaction = 0.088). Compared with those in the lowest quartile (Q1), male participants in the highest adiponectin quartile (Q4) had reduced risks of BP progression (RR 0.76 [95% confidence interval, CI, 0.60-0.96]) and incident hypertension (RR 0.74 [95% CI 0.56-0.97]). After accounting for body mass index, this relation persisted among obese men (RR for the highest [vs. lowest] adiponectin quartile: 0.59 [95% CI 0.36-0.97] for incident hypertension, and 0.69 [95% CI 0.45-1.06] for BP progression). Among women, adiponectin was not associated with BP outcomes (RR [95% CI] for Q4 vs. Q1: 1.03 [0.86-1.23] and 1.01 [0.83-1.23] for BP progression and incident hypertension, respectively). Our findings were consistent across both the American College of Cardiology (ACC)/American Heart Association (AHA) and Seventh Joint National Committee (JNC-7) BP categories.

CONCLUSIONS

In a large, community-based sample of AAs, higher adiponectin concentrations were associated with lower risks of BP progression and incident hypertension in men, but no significant association was observed in women.

摘要

背景

关于非裔美国人(AA)血浆脂联素与血压(BP)变化之间的关联,人们了解甚少。我们评估了AA人群中血浆脂联素与BP进展之间的关联。

方法

我们分析了杰克逊心脏研究中1184名基线时(2000 - 2004年)无高血压且有≥1次随访的参与者的数据。我们使用稳健泊松回归来生成BP进展(BP阶段增加≥1个阶段)和新发高血压的风险比(RR)。

结果

在中位7年的时间里,71%的人进展到更高的BP阶段,65%的人患高血压。我们发现了性别交互作用的证据(P交互作用 = 0.088)。与脂联素最低四分位数(Q1)的男性相比,脂联素最高四分位数(Q4)的男性参与者BP进展风险降低(RR 0.76 [95%置信区间,CI,0.60 - 0.96]),新发高血压风险降低(RR 0.74 [95% CI 0.56 - 0.97])。在考虑体重指数后,这种关系在肥胖男性中仍然存在(脂联素最高[与最低]四分位数的RR:新发高血压为0.59 [95% CI 0.36 - 0.97],BP进展为0.69 [95% CI 0.45 - 1.06])。在女性中,脂联素与BP结局无关(Q4与Q1的RR [95% CI]:BP进展分别为1.03 [0.86 - 1.23],新发高血压为1.01 [0.83 - 1.23])。我们的研究结果在美国心脏病学会(ACC)/美国心脏协会(AHA)和第七届全国联合委员会(JNC - 7)的BP分类中都是一致的。

结论

在一个基于社区的大型AA样本中,较高的脂联素浓度与男性较低的BP进展和新发高血压风险相关,但在女性中未观察到显著关联。

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