Szaló Gábor, Hellgren Margareta I, Allison Matthew, Li Ying, Råstam Lennart, Rådholm Karin, Bollano Entela, Duprez Daniel A, Jacobs David R, Lindblad Ulf, Daka Bledar
Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
The Skaraborg Institute, Skövde, Sweden.
J Hum Hypertens. 2024 Feb;38(2):140-145. doi: 10.1038/s41371-023-00867-1. Epub 2023 Oct 4.
It is still debated whether arterial elasticity provides prognostic information for cardiovascular risk beyond blood pressure measurements in a healthy population. To investigate the association between arterial elasticity obtained by radial artery pulse wave analysis and risk for cardiovascular diseases (CVD) in men and women. In 2002-2005, 2362 individuals (men=1186, 50.2%) not taking antihypertensive medication were included. C2 (small artery elasticity) was measured using the HDI/Pulse Wave CR2000. Data on acute myocardial infarction or stroke, fatal or non-fatal, was obtained between 2002-2019. Cox- regression was used to investigate associations between C2 and future CVD, adjusting for confounding factors such as age, sex, systolic blood pressure, heart rate, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LDL- cholesterol, CRP (C-Reactive Protein), alcohol consumption, smoking and physical activity. At baseline, the mean age of 46 ± 10.6 years and over the follow-up period, we observed 108 events 70 events in men [event rate: 5.9%], 38 in women [event rate: 3.2%]. In the fully adjusted model, and for each quartile decrease in C2, there was a significant increase in the risk for incident CVD by 36%. (HR = 1.36, 95% CI: 1.01-1.82, p = 0.041). The results were accentuated for all men (HR = 1.74, 95% CI: 1.21-2.50, p = 0.003) and women over the age of 50 years (HR = 1.70, 95% CI: 0.69-4.20). We showed a strong and independent association between C2 and CVD in men. In women after menopause, similar tendencies and effect sizes were observed.
在健康人群中，动脉弹性是否能提供超出血压测量的心血管风险预后信息仍存在争议。旨在研究通过桡动脉脉搏波分析获得的动脉弹性与男性和女性心血管疾病（CVD）风险之间的关联。在2002年至2005年期间，纳入了2362名未服用抗高血压药物的个体（男性=1186名，占50.2%）。使用HDI/脉搏波CR2000测量C2（小动脉弹性）。在2002年至2019年期间获取了急性心肌梗死或中风（致命或非致命）的数据。采用Cox回归研究C2与未来CVD之间的关联，并对年龄、性别、收缩压、心率、HOMA-IR（胰岛素抵抗稳态模型评估）、低密度脂蛋白胆固醇、CRP（C反应蛋白）、饮酒、吸烟和身体活动等混杂因素进行校正。在基线时，平均年龄为46±10.6岁，在随访期间，我们观察到108例事件，男性70例[事件发生率：5.9%]，女性38例[事件发生率：3.2%]。在完全校正模型中，C2每降低一个四分位数，新发CVD风险显著增加36%。（HR=1.36，95%CI：1.01-1.82，p=0.041）。所有男性（HR=1.74，95%CI：1.21-2.50，p=0.003）和50岁以上女性（HR=1.70，95%CI：0.69-4.20）的结果更为明显。我们发现男性中C2与CVD之间存在强烈的独立关联。在绝经后女性中也观察到了类似的趋势和效应大小。
