Chen Zheng-Wei, Pan Chien-Ting, Tsai Cheng-Hsuan, Chang Yi-Yao, Chang Chin-Chen, Lee Bo-Ching, Chiu Yu-Wei, Huang Wei-Chieh, Lin Yu-Li, Wu Vin-Cent, Hung Chi-Sheng, Liao Che-Wei, Lin Yen-Hung
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin 640, Taiwan.
Biomedicines. 2021 Sep 22;9(10):1285. doi: 10.3390/biomedicines9101285.
Primary aldosteronism (PA) is associated with higher arterial stiffness compared to essential hypertension (EH). However, few studies have compared different pulse wave velocity (PWV) parameters to detect aldosterone-induced arterial stiffness. In this study, we aimed to compare the sensitivity in detecting aldosterone-induced arterial stiffness between brachial-ankle PWV (baPWV) and heart-ankle PWV (haPWV). We prospectively enrolled 1006 PA patients and 983 EH patients. Detailed medical history, basic biochemistry data and two PWV measurements (baPWV and haPWV) were collected in both groups. We performed analysis on the original cohort and two propensity score matching (PSM) models (model 1 adjusted for age and sex; model 2 adjusted for age, sex, systolic and diastolic blood pressure). The DeLong test was used to compare areas under receiver operating characteristic curves (AUCs) between baPWV and haPWV to predict PA. In all models, the PA patients had significantly higher baPWV compared to the EH patients. The AUC of haPWV was greater than that of baPWV. In conclusion, haPWV seems to be a better PWV parameter than baPWV in detecting aldosterone-induced arterial stiffness.
与原发性高血压（EH）相比，原发性醛固酮增多症（PA）与更高的动脉僵硬度相关。然而，很少有研究比较不同的脉搏波速度（PWV）参数来检测醛固酮诱导的动脉僵硬度。在本研究中，我们旨在比较臂踝脉搏波速度（baPWV）和心踝脉搏波速度（haPWV）在检测醛固酮诱导的动脉僵硬度方面的敏感性。我们前瞻性纳入了1006例PA患者和983例EH患者。两组均收集了详细的病史、基本生化数据以及两项PWV测量值（baPWV和haPWV）。我们对原始队列以及两个倾向评分匹配（PSM）模型（模型1根据年龄和性别进行调整；模型2根据年龄、性别、收缩压和舒张压进行调整）进行了分析。使用DeLong检验比较baPWV和haPWV之间预测PA的受试者工作特征曲线下面积（AUC）。在所有模型中，与EH患者相比，PA患者的baPWV显著更高。haPWV的AUC大于baPWV。总之，在检测醛固酮诱导的动脉僵硬度方面，haPWV似乎是比baPWV更好的PWV参数。
