Zuo Junli, Tang Biwen, O'Rourke Michael F, Avolio Alberto P, Adji Audrey
Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Faculty of Medicine, Health and Human Sciences, Macquarie (University) Medical School, Sydney 2109, Australia.
J Cardiovasc Dev Dis. 2022 Mar 3;9(3):75. doi: 10.3390/jcdd9030075.
Objectives: Arterial stiffness is widely accepted as an important predictor of cardiovascular disease (CVD) development. While obesity is generally associated with increased CVD risk, there is evidence that overweight patients with existing CVD may have better clinical outcomes than their lean counterparts. Our study sought to observe any potential association between brachial−ankle pulse wave velocity (BAPWV), a marker of arterial stiffness related to CVD risk, and Body Mass Index (BMI), a crude and widely used measure of obesity. Methods: Adult individuals (n = 857) assessed for routine CV risk were included and grouped according to their BMI (<25 kg/m2: normal; 25−30 kg/m2: overweight, ≥30 kg/m2: obese). Their anthropometric parameters, brachial cuff pressures, and BAPWV were measured. Results: Brachial pressure was significantly higher as BMI increased. BAPWV showed a positive linear association with systolic (r = 0.66, p < 0.01), mean (r = 0.60, p < 0.01), diastolic (r = 0.51, p < 0.01), and pulse (r = 0.53, p < 0.01) pressures. However, a linear relationship between BMI and BAPWV was only apparent in males aged <50 years (p = 0.01) and in females aged ≥50 years (p < 0.01). In individuals with similar brachial systolic pressure, BAPWV was higher in normal-weight subjects compared to overweight−obese ones. Conclusions: This conflicting finding is attributed to an overestimation of the degree of arterial stiffness as a measure of CVD risk in individuals with a less ‘healthy’ BMI. This suggests that BMI may not the appropriate obesity indicator to assess CV risk. Our finding emphasizes the importance of establishing a non-linear relationship between CVD risk, age, and BMI, taking into account apparent sex differences, to predict future CV events. While this finding may suggest a lower degree of stiffness in large arteries of overweight−obese subjects compared to their normal-weight counterparts, the potential implications for individuals with higher BMI need be explored further.
动脉僵硬度被广泛认为是心血管疾病（CVD）发展的重要预测指标。虽然肥胖通常与CVD风险增加相关，但有证据表明，患有现有CVD的超重患者可能比瘦患者有更好的临床结果。我们的研究旨在观察肱踝脉搏波速度（BAPWV，一种与CVD风险相关的动脉僵硬度标志物）与体重指数（BMI，一种粗略且广泛使用的肥胖测量指标）之间的任何潜在关联。方法：纳入接受常规心血管风险评估的成年个体（n = 857），并根据其BMI进行分组（<25 kg/m²：正常；25 - 30 kg/m²：超重，≥30 kg/m²：肥胖）。测量他们的人体测量参数、肱动脉袖带压力和BAPWV。结果：随着BMI增加，肱动脉压力显著升高。BAPWV与收缩压（r = 0.66，p < 0.01）、平均压（r = 0.60，p < 0.01）、舒张压（r = 0.51，p < 0.01）和脉压（r = 0.53，p < 0.01）呈正线性相关。然而，BMI与BAPWV之间的线性关系仅在年龄<50岁的男性（p = 0.01）和年龄≥50岁的女性（p < 0.01）中明显。在肱动脉收缩压相似的个体中，正常体重受试者的BAPWV高于超重 - 肥胖受试者。结论：这一相互矛盾的发现归因于在BMI不太“健康”的个体中，作为CVD风险测量指标的动脉僵硬度程度被高估。这表明BMI可能不是评估心血管风险的合适肥胖指标。我们的发现强调了在考虑明显的性别差异的情况下，建立CVD风险、年龄和BMI之间的非线性关系以预测未来心血管事件的重要性。虽然这一发现可能表明超重 - 肥胖受试者的大动脉僵硬度程度低于其正常体重的对应者，但对于BMI较高的个体的潜在影响需要进一步探索。
