Chao Huijuan, He Yan, Wang Qian, Bai Yaya, Avolio Alberto, Deng Xueqin, Zuo Junli
Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 Jul 5;9:934747. doi: 10.3389/fcvm.2022.934747. eCollection 2022.
Assessment of target organ damage (TOD) is an important part of the diagnosis and evaluation of hypertension. Carotid-femoral pulse wave velocity (cf-PWV) is considered to be the gold-standard for noninvasive arterial stiffness assessment. This study aims to analyze the risk of TOD in people with different phenotypes of peripheral blood pressure and cf-PWV.
The study cohort was recruited from December 2017 to September 2021 at Ruijin Hospital in Shanghai. It was divided into 4 groups according to peripheral blood pressure (pBP) and cf-PWV. TOD was assessed as carotid intima-media thickness (CIMT), chronic kidney disease (CKD), urinary albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI).
A total of 1,257 subjects (mean age 53.13 ± 12.65 years, 64.2% males) was recruited. Age, body mass index (BMI) and fasting blood glucose (FBG), as well as peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), peripheral pulse pressure (pPP) were significantly different in the four groups ( < 0.01). eGFR, ACR, LVMI and CIMT were significantly different among different groups ( < 0.01). The risk of ACR abnormality was significantly higher in the group with elevated pBP ( = 0.005, OR 2.264, 95%CI 1.277-4.016; and in the group with elevated pBP and cf-PWV ( = 0.003, OR 1.482, 95%CI 1.144-1.920), while left ventricular hypertrophy (LVH) was significantly higher in the group with elevated cf-PWV ( = 0.002, OR 1.868, 95%CI 1.249-2.793).
Different profiles based on the status of PBP and cf-PWV associated with different TOD. Individuals with higher pBP have an increased risk of ACR abnormality, while individuals with only cf-PWV elevated have a higher risk of LVH.
评估靶器官损害（TOD）是高血压诊断和评估的重要组成部分。颈股脉搏波速度（cf-PWV）被认为是无创动脉僵硬度评估的金标准。本研究旨在分析不同外周血压和cf-PWV表型人群的TOD风险。
研究队列于2017年12月至2021年9月在上海瑞金医院招募。根据外周血压（pBP）和cf-PWV分为4组。TOD评估指标为颈动脉内膜中层厚度（CIMT）、慢性肾脏病（CKD）、尿白蛋白肌酐比值（ACR）、估算肾小球滤过率（eGFR）和左心室质量指数（LVMI）。
共招募1257名受试者（平均年龄53.13±12.65岁，男性占64.2%）。四组受试者的年龄、体重指数（BMI）、空腹血糖（FBG）以及外周收缩压（pSBP）、外周舒张压（pDBP）、外周脉压（pPP）存在显著差异（<0.01）。不同组间eGFR、ACR、LVMI和CIMT存在显著差异（<0.01）。pBP升高组ACR异常风险显著更高（=0.005，OR 2.264，95%CI 1.277-4.016）；pBP和cf-PWV均升高组ACR异常风险也显著更高（=0.003，OR 1.482，95%CI 1.144-1.920），而cf-PWV升高组左心室肥厚（LVH）风险显著更高（=0.002，OR 1.868，95%CI 1.249-2.793）。
基于pBP和cf-PWV状态的不同特征与不同的TOD相关。pBP较高的个体ACR异常风险增加，而仅cf-PWV升高的个体LVH风险更高。
