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中国高血压成年人中基线肱踝脉搏波速度与首次中风短期风险之间的关联。

Association between baseline brachial-ankle pulse wave velocity and short-term risk of first stroke among Chinese hypertensive adults.

作者信息

Hu Lihua, Bi Chonglei, Liu Lishun, Song Yun, Zhang Yue, Wang Binyan, Fang Chongqian, Ma Hai, Huang Xiao, Zhang Yan, Bao Huihui, Li Ping, Xu Xiping, Wang Xiaobin, Cheng Xiaoshu, Huo Yong, Li Jianping

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, China.

People's Hospital of Rongcheng, Rongcheng, Shandong, China.

出版信息

J Hum Hypertens. 2022 Dec;36(12):1085-1091. doi: 10.1038/s41371-021-00611-7. Epub 2021 Nov 15.

Abstract

Little information is available on the association between brachial-ankle pulse wave velocity (baPWV) and the risk of stroke in Chinese H-type hypertension patients. Therefore, our study aimed to assess this association between baseline baPWV and short-term risk of first stroke and to propose a cutoff value of baPWV that could predict near cerebrovascular events. A total of 9787 hypertension patients without preexisting stroke who underwent baPWV measurement were included. The primary end points were first symptomatic stroke. Secondary end points were first ischemic stroke and first hemorrhagic stroke. During a median follow-up of 20.8 months, there was a total of 138 first strokes including 123 first ischemic strokes and 15 first hemorrhagic strokes. When baPWV was categorized in quartiles, the higher risks of first stroke (HR = 1.52; 95% CI: 1.05-2.21) and first ischemic stroke (HR = 1.53; 95% CI: 1.03-2.26) were found in participants in quartile 4 (≥21.31 m/s), compared with those in quartile 1-3 (<21.31 m/s). In receiver operating characteristic curve analysis, the best cutoff value of baPWV that could predict first stroke was 21.43 m/s. Higher baPWV (≥21.43 m/s) was significantly associated with increased risk of first stroke (HR = 1.60; 95% CI: 1.10-2.32) and first ischemic stroke (HR = 1.60; 95% CI: 1.08-2.37). In conclusion, higher baPWV levels were associated with an increased risk of first stroke among Chinese H-type hypertensive patients. In addition, a cutoff value of 21.43 m/s of baPWV was proposed that could predict the next two years' cerebrovascular events.

摘要

关于中国H型高血压患者的臂踝脉搏波速度(baPWV)与中风风险之间的关联,目前可用信息较少。因此,我们的研究旨在评估基线baPWV与首次中风的短期风险之间的这种关联,并提出一个能够预测近期脑血管事件的baPWV临界值。总共纳入了9787例未发生过中风且接受了baPWV测量的高血压患者。主要终点是首次有症状性中风。次要终点是首次缺血性中风和首次出血性中风。在中位随访20.8个月期间,共有138例首次中风,包括123例首次缺血性中风和15例首次出血性中风。当将baPWV按四分位数分类时,与四分位数1 - 3(<21.31 m/s)的参与者相比,四分位数4(≥21.31 m/s)的参与者发生首次中风(HR = 1.52;95% CI:1.05 - 2.21)和首次缺血性中风(HR = 1.53;95% CI:1.03 - 2.26)的风险更高。在受试者工作特征曲线分析中,能够预测首次中风的baPWV最佳临界值为21.43 m/s。较高的baPWV(≥21.43 m/s)与首次中风(HR = 1.60;95% CI:1.10 - 2.32)和首次缺血性中风(HR = 1.60;95% CI:1.08 - 2.37)风险增加显著相关。总之,较高的baPWV水平与中国H型高血压患者首次中风风险增加相关。此外,提出了baPWV的临界值为21.43 m/s,其能够预测未来两年的脑血管事件。

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