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班图中非裔高血压患者颈动脉内膜中层厚度变化与心血管代谢风险的相关性:来自 Monkole 和 Biamba Marie Mutombo 医院的研究

Are Any Changes in Carotid Intima-Media Thickness Associated with Cardiometabolic Risk Among Adult Bantu Central African Hypertensive Patients from Monkole and Biamba Marie Mutombo Hospitals?

机构信息

Radiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo.

Cardiology Service, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of Congo.

出版信息

Vasc Health Risk Manag. 2022 Jul 1;18:453-461. doi: 10.2147/VHRM.S366339. eCollection 2022.

Abstract

BACKGROUND

Several classic/traditional risk factors are associated with intima-media thickness (IMT), a novel risk of cardio metabolic risk (CMR) in the literature but not in Kinshasa, a megacity prone to CMR. Thus, the objective of this study was to evaluate potential correlations between inflammation, kidney function, psychological stress, hemodynamics, and changes in IMT.

METHODS

This cross-sectional study was carried out between 2018 and 2021 within Monkole and Biamba Marie Mutombo Hospitals, respectively, and randomly selected from 10 health structures from East and West of Kinshasa, Capital of Democratic Republic Congo (DRC). A random sample of adult hypertensive Bantu Central Africans was examined after bivariate correlations and multiple linear regression.

RESULTS

Out of 280 patients with 140 men and 140 women aged 62 ± 11 years, the mean carotid intima-media thickness (CIMT) was 1.06 ± 0.5 mm and 73% (n = 204) patients had uncontrolled hypertension. After controlling for confounders, 52.9% variations (R2) of CIMT were independently and significantly (P = 0.037) predicted by CRP, 24-hour proteinuria, urinary albumin/creatinine ratio, duration of hypertension, heart rate, hip circumference, and psychological stress with Equation Y = 0.717 + 0.87 × CRP + 0.02 × 24 H - proteinuria + 0.005 × urinary albumin/creatinine ratio + 0.05 × duration of hypertension + 0.001 × heart rate + 0.006 × hip circumference + 0.017 × psychological stress.

CONCLUSION

There is an urgent need to control inflammation, impaired renal function, cardiac rhythm, peripheral obesity, longer duration of hypertension management, and stress, which are emerging as specific novel determinants of the subclinical atherosclerosis for those Bantu Central African hypertensive patients.

摘要

背景

一些经典/传统的风险因素与内中膜厚度(IMT)有关,这是文献中代谢风险(CMR)的一个新风险,但在金沙萨却没有,金沙萨是一个容易发生 CMR 的大都市。因此,本研究的目的是评估炎症、肾功能、心理压力、血液动力学与 IMT 变化之间的潜在相关性。

方法

这是一项横断面研究,于 2018 年至 2021 年期间在金沙萨的 Monkole 和 Biamba Marie Mutombo 医院进行,分别从刚果民主共和国首都金沙萨东西部的 10 个卫生机构中随机选择。对 140 名男性和 140 名女性的成年中非班图高血压患者进行了随机抽样检查,然后进行了双变量相关性和多元线性回归分析。

结果

在 280 名患者中,有 140 名男性和 140 名女性,年龄为 62 ± 11 岁,颈动脉内中膜厚度(CIMT)平均值为 1.06 ± 0.5 毫米,73%(n = 204)患者的高血压未得到控制。在控制了混杂因素后,CIMT 的 52.9%变化(R2)可独立且显著地(P = 0.037)由 CRP、24 小时蛋白尿、尿白蛋白/肌酐比值、高血压持续时间、心率、臀围和心理压力来预测,方程为 Y = 0.717 + 0.87×CRP + 0.02×24 小时蛋白尿 + 0.005×尿白蛋白/肌酐比值 + 0.05×高血压持续时间 + 0.001×心率 + 0.006×臀围 + 0.017×心理压力。

结论

迫切需要控制炎症、肾功能受损、心律失常、外周性肥胖、高血压管理时间延长和压力,这些都是中非班图高血压患者亚临床动脉粥样硬化的新兴特定新决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56e/9255902/13720b5c81bf/VHRM-18-453-g0001.jpg

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