Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
J Hum Hypertens. 2024 May;38(5):460-466. doi: 10.1038/s41371-024-00902-9. Epub 2024 Feb 27.
It has not been fully investigated whether improved arterial stiffness (AS) can reduce the clinical outcomes risk in community population-based study. In this prospective study, a total of 5247 individuals with abnormal AS (at baseline) and repeated brachial-ankle pulse wave velocity (baPWV) measurement before 2018 years were enrolled from the Kailuan Study. According the second baPWV measurement, we divided the participants into two groups, improved AS (defined as transfer elevated AS status to normal) and persistent AS (defined as maintaining elevated AS status). The outcome was a composite event of stroke, myocardial infraction, and all-cause mortality. We used Cox proportional hazards regression to examine the association between AS status at the follow-up and the subsequent outcome. During a median of 5.2 years follow-up, we observed 413 end point events. After adjusted for potential confounders, comparing with the persistent AS group, individuals in the improved AS group had a 43% (hazard ratio [HR], 0.57; 95% confidence interval [CI] 0.35-0.94) decreased the risk of the primary composite events. We also found a baPWV decrease of 1 m/s was associated with a 3% decreased risk (HR, 0.97; 95% CI 0.94-0.99) for primary composite events. We further demonstrated that younger than 60 years, non-smoker, non-hypertension, and non-diabetes were associated with improved the AS status. In conclusion, improving AS status may reduce the risk of clinical events. In the future, more research should be performed to explore the target for improving the AS status.
尚未充分研究社区人群中动脉僵硬度（AS）改善是否能降低临床结局风险。在这项前瞻性研究中，共纳入了 5247 名 AS 异常（基线时）且在 2018 年前重复进行了肱踝脉搏波速度（baPWV）测量的个体。根据第二次 baPWV 测量结果，我们将参与者分为两组，改善的 AS（定义为将升高的 AS 状态转为正常）和持续的 AS（定义为维持升高的 AS 状态）。结局是卒中、心肌梗死和全因死亡率的复合事件。我们使用 Cox 比例风险回归分析来研究随访时的 AS 状态与随后结局之间的关系。在中位 5.2 年的随访期间，我们观察到 413 例终点事件。在校正了潜在混杂因素后，与持续的 AS 组相比，改善的 AS 组发生主要复合事件的风险降低了 43%（风险比 [HR]，0.57；95%置信区间 [CI]，0.35-0.94）。我们还发现，baPWV 降低 1m/s 与主要复合事件风险降低 3%（HR，0.97；95%CI，0.94-0.99）相关。我们进一步表明，年龄小于 60 岁、不吸烟、无高血压和无糖尿病与改善 AS 状态相关。总之，改善 AS 状态可能降低临床事件风险。未来需要开展更多研究以探索改善 AS 状态的目标。
