Cao Z W, Han X, Li J, Zhang J, Ji M L, Liu L W, Zhao H Y, Wu Y T
Department of Cardiology, Luanzhou People's Hospital, Luanzhou 063700, China.
Graduate School, North China University of Science and Technology, Tangshan 063000, China Department of Cardiology, Kailuan General Hospital, Tangshan 063000, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2023 Mar 24;51(3):296-302. doi: 10.3760/cma.j.cn112148-20230117-00033.
To evaluate the impact of individual and combined assessment of age- and sex-specific brachial-ankle pulse wave velocity (baPWV) and pulse pressure (PP) on all-cause mortality. This study is a prospective cohort study. Individuals participated in the Kailuan Study and completed baPWV measurements between 2010 and 2016 were included in this study. After stratifying by sex, 75th percentile baPWV and PP values for different age group were calculated at five years interval. BaPWV and PP values below the 75th percentile were defined as normal, and those above or equal to the 75th percentile were defined as increased. The participants were allocated to four groups according to their PP and baPWV status: normal baPWV/PP group, high baPWV/normal PP group, normal baPWV/high PP group and high baPWV/PP group. The primary outcome was all-cause mortality during the follow-up period. Cox proportional hazards models were used to explore the impact of individual and combined assessment of baPWV and PP on all-cause mortality events. A total of 39 339 participants were enrolled in this study, aged (49.3±12.8) years, of which 28 731 (73.03%) were males. There were 23 268, 6 025, 6 210 and 3 836 cases in the normal baPWV/PP group, high baPWV/normal PP group, normal baPWV/high PP group and high baPWV/PP group, respectively. The average follow-up duration was (4.98±2.53) years. During the follow-up period, all-cause mortality occurred in 998 individuals. Multivariate Cox regression analysis showed increased risk of all-cause mortality in the high baPWV/normal PP group (=1.27, 95% 1.07-1.50), and in the high baPWV/PP group (=1.33, 95%CI 1.08-1.65) compared to the normal baPWV/PP group. Increased pulse pressure alone had no impcat on all-cause death (=1.06, 95% 0.87-1.29). The risk of all-cause mortality significantly increases with increased age-and sex-specific baPWV and PP values. BaPWV may be a better predictor of all-cause mortality than PP in this cohort.
评估年龄和性别特异性臂踝脉搏波速度（baPWV）与脉压（PP）的单独及联合评估对全因死亡率的影响。本研究为前瞻性队列研究。纳入参加开滦研究并在2010年至2016年期间完成baPWV测量的个体。按性别分层后，每隔五年计算不同年龄组的baPWV和PP的第75百分位数。baPWV和PP值低于第75百分位数定义为正常，高于或等于第75百分位数定义为升高。参与者根据其PP和baPWV状态分为四组：正常baPWV/PP组、高baPWV/正常PP组、正常baPWV/高PP组和高baPWV/PP组。主要结局为随访期间的全因死亡率。采用Cox比例风险模型探讨baPWV和PP的单独及联合评估对全因死亡事件的影响。本研究共纳入39339名参与者，年龄为（49.3±12.8）岁，其中28731名（73.03%）为男性。正常baPWV/PP组、高baPWV/正常PP组、正常baPWV/高PP组和高baPWV/PP组分别有23268例、6025例、6210例和3836例。平均随访时间为（4.98±2.53）年。随访期间，998例个体发生全因死亡。多因素Cox回归分析显示，与正常baPWV/PP组相比，高baPWV/正常PP组（=1.27，95% 1.07 - 1.50）和高baPWV/PP组（=1.33，95%CI 1.08 - 1.65）全因死亡风险增加。单纯脉压升高对全因死亡无影响（=1.06，95% 0.87 - 1.29）。年龄和性别特异性baPWV和PP值升高时，全因死亡风险显著增加。在该队列中，baPWV可能比PP是更好的全因死亡率预测指标。
