Han Yiming, Maruhashi Tatsuya, Kajikawa Masato, Kishimoto Shinji, Yamaji Takayuki, Harada Takahiro, Hashimoto Yu, Yusoff Farina Mohamad, Nakano Yukiko, Chayama Kazuaki, Nakashima Ayumu, Goto Chikara, Yoshimura Kenichi, Higashi Yukihito
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
Hypertens Res. 2022 Apr;45(4):698-707. doi: 10.1038/s41440-022-00854-y. Epub 2022 Feb 3.
Hypertension is associated with an impairment of endothelial function. However, it is unclear whether isolated diastolic hypertension is associated with endothelial dysfunction. The purpose of this study was to investigate the association of endothelial function with isolated diastolic hypertension diagnosed by using two major hypertension guidelines: systolic blood pressure (BP) < 130 mmHg and diastolic BP ≥ 80 mmHg according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline and systolic BP < 140 mmHg and diastolic BP ≥ 90 mmHg according to the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) hypertension guideline. We measured the flow-mediated vasodilation (FMD) of the brachial artery in subjects without systolic hypertension who were not treated with antihypertensive drugs. Of 3727 subjects (2813 men; mean age: 41.3 ± 10.9 years), 749 (20.1%) had isolated diastolic hypertension according to the 2017 ACC/AHA definition. Multiple logistic regression analysis revealed that isolated diastolic hypertension was not associated with endothelial dysfunction, defined as FMD < 7.0% (OR, 1.15; 95% CI, 0.98-1.35; P = 0.09). Of 4747 subjects (3727 men; mean age: 45.1 ± 10.8 years), 314 subjects (6.6%) had isolated diastolic hypertension according to the ESC/ESH definition. Multiple logistic regression analysis revealed that isolated diastolic hypertension was not associated with endothelial dysfunction after adjusting for age and sex (OR, 1.04; 95% CI, 0.82-1.32; P = 0.76). Isolated diastolic hypertension was not associated with endothelial dysfunction in individuals who were not treated with antihypertensive drugs regardless of the major hypertension guideline definition used.
高血压与内皮功能受损有关。然而，单纯舒张期高血压是否与内皮功能障碍相关尚不清楚。本研究的目的是根据两项主要高血压指南，调查内皮功能与单纯舒张期高血压之间的关联：根据2017年美国心脏病学会/美国心脏协会（ACC/AHA）高血压指南，收缩压（BP）<130 mmHg且舒张压BP≥80 mmHg；根据2018年欧洲心脏病学会/欧洲高血压学会（ESC/ESH）高血压指南，收缩压BP<140 mmHg且舒张压BP≥90 mmHg。我们测量了未接受降压药物治疗的无收缩期高血压受试者肱动脉的血流介导的血管舒张（FMD）。在3727名受试者（2813名男性；平均年龄：41.3±10.9岁）中，根据2017年ACC/AHA定义，749名（20.1%）患有单纯舒张期高血压。多因素logistic回归分析显示，单纯舒张期高血压与定义为FMD<7.0%的内皮功能障碍无关（OR，1.15；95%CI，0.98 - 1.35；P = 0.09）。在4747名受试者（3727名男性；平均年龄：45.1±10.8岁）中，根据ESC/ESH定义，314名（6.6%）患有单纯舒张期高血压。多因素logistic回归分析显示，在调整年龄和性别后，单纯舒张期高血压与内皮功能障碍无关（OR，1.04；95%CI，0.82 - 1.32；P = 0.76）。无论使用何种主要高血压指南定义，未接受降压药物治疗的个体中，单纯舒张期高血压与内皮功能障碍无关。
