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心血管危险因素对动脉僵硬度的缓慢和快速进展的终身异质性贡献。

Lifelong Heterogeneous Contribution of Cardiovascular Risk Factors to Slow and Fast Progression of Arterial Stiffness.

机构信息

Department of Cardiology (H.T., K.S., H.N., T.T., M.F., C.M., T.C.), Tokyo Medical University, Japan.

Division of Preemptive Medicine for Vascular Damage (H.T., K.S.), Tokyo Medical University, Japan.

出版信息

Hypertension. 2023 Oct;80(10):2159-2168. doi: 10.1161/HYPERTENSIONAHA.123.21481. Epub 2023 Aug 8.

Abstract

BACKGROUND

Although some cardiovascular risk factors (CVRFs) are known to be associated with increased arterial stiffness, increased arterial stiffness does not mediate the cardiovascular risk associated with all CVRFs. Here, based on long-term repeated-measurement data, we examined the association of the lifelong status of each CVRF with the rate of progression of arterial stiffness.

METHODS

We utilized the data from annual health checkups with the brachial-ankle pulse wave velocity measurements over a 16-year period in middle-aged Japanese occupational cohort.

RESULTS

Totally, 29 090 brachial-ankle pulse wave velocity data were obtained during the follow-up of 3763 subjects ranging in age from around 30 to 70 years. Smoking, heavy alcohol intake, hypertension, diabetes, hypertriglyceridemia, and hyperuricemia were independently associated with the fast progression of arterial stiffness. Also, lower values in nondisease range in blood pressure, glycosylated hemoglobin A1c, triglyceride, and uric acid were independently associated with the slow progression of arterial stiffness. For body mass index and low-density lipoprotein cholesterol, no clear associations with the progression of arterial stiffness were observed.

CONCLUSIONS

The present prospective study provided more robust epidemiological evidence for the heterogeneity of the significance of contribution of lifelong status of each CVRF to the slow and fast rate of progression of arterial stiffness. These findings suggest the important need to examine, in further studies, the effects of global early interventions to control the levels of the culprit CVRFs, even from middle age, not only to prevent a fast progression of the arterial stiffness but also to maintain a relatively slow progression of arterial stiffness.

摘要

背景

虽然一些心血管危险因素(CVRFs)与动脉僵硬程度增加有关,但动脉僵硬程度并不能解释所有 CVRFs 相关的心血管风险。在这里,我们基于长期重复测量数据,研究了每个 CVRF 的终身状态与动脉僵硬程度进展率之间的关联。

方法

我们利用了日本中年职业队列中 16 年期间每年进行的健康检查和肱踝脉搏波速度测量数据。

结果

在 3763 名年龄在 30 岁至 70 岁之间的受试者的随访中,共获得了 29090 次肱踝脉搏波速度数据。吸烟、大量饮酒、高血压、糖尿病、高甘油三酯血症和高尿酸血症与动脉僵硬的快速进展独立相关。此外,血压、糖化血红蛋白 A1c、甘油三酯和尿酸的非疾病范围值较低与动脉僵硬的缓慢进展独立相关。对于体重指数和低密度脂蛋白胆固醇,与动脉僵硬的进展没有明显的关联。

结论

本前瞻性研究为每个 CVRF 的终身状态对动脉僵硬缓慢和快速进展的贡献意义的异质性提供了更有力的流行病学证据。这些发现表明,在进一步的研究中,需要研究全球早期干预措施的效果,以控制致病 CVRF 的水平,即使从中年开始,不仅要预防动脉僵硬的快速进展,还要维持动脉僵硬的相对缓慢进展,这一点非常重要。

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