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原发性高血压患者腹主动脉钙化与冠心病的关联:一项基于2013 - 2014年美国国家健康与营养检查调查的横断面研究

Association between Abdominal Aortic Calcification and Coronary Heart Disease in Essential Hypertension: A Cross-Sectional Study from the 2013-2014 National Health and Nutrition Examination Survey.

作者信息

He Lan, Li Xu, Shen E, He Yong-Ming

机构信息

Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Ave., Gusu District, Suzhou 215006, China.

Department of Ultrasound, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, 241 Huaihai West Road, Xuhui District, Shanghai 200030, China.

出版信息

J Cardiovasc Dev Dis. 2024 May 2;11(5):143. doi: 10.3390/jcdd11050143.

Abstract

BACKGROUND

This study aimed to investigate the association between abdominal aortic calcification (AAC) and coronary heart disease (CHD) in essential hypertension (EH).

METHODS

This study included patients diagnosed with EH during the 2013-2014 NHANES survey cycle. The study cohort was categorized into the following four groups based on their AAC-24 score: no AAC (0); mild AAC (1-4); moderate AAC (5-15); and severe AAC (16-24). Logistic regression models were used to assess the association between AAC and CHD. Restricted cubic spline curves (RCS) were used to explore possible nonlinear relationships between AAC and CHD.

RESULTS

The prevalence of CHD was found to be higher in the moderate AAC and severe AAC groups than in the group without AAC (40.1% versus 30.9%, 47.7% versus 30.9%). On a continuous scale, the fully adjusted model showed a 7% increase in the risk of CHD prevalence per score increase in AAC [OR (95% CI) = 1.07 (1.03-1.11)]. On a categorical scale, the fully adjusted model showed the risk of CHD prevalence in EH patients with moderate AAC and severe AAC was 2.06 (95%CI, 1.23-3.45) and 2.18 (1.09-5.25) times higher than that in patients without AAC, respectively. The RCS curve suggested a dose-response linear relationship between AAC and CHD.

CONCLUSION

These findings highlight that in patients with EH, a higher severity of AAC is associated with a higher risk of CHD prevalence.

摘要

背景

本研究旨在探讨原发性高血压(EH)患者腹主动脉钙化(AAC)与冠心病(CHD)之间的关联。

方法

本研究纳入了在2013 - 2014年美国国家健康与营养检查调查(NHANES)周期中被诊断为EH的患者。根据其AAC - 24评分,将研究队列分为以下四组:无AAC(0);轻度AAC(1 - 4);中度AAC(5 - 15);重度AAC(16 - 24)。采用逻辑回归模型评估AAC与CHD之间的关联。使用受限立方样条曲线(RCS)探索AAC与CHD之间可能的非线性关系。

结果

发现中度AAC组和重度AAC组的CHD患病率高于无AAC组(分别为40.1%对30.9%,47.7%对30.9%)。在连续尺度上,完全调整模型显示AAC每增加一分,CHD患病率风险增加7%[比值比(95%置信区间)= 1.07(1.03 - 1.11)]。在分类尺度上,完全调整模型显示,中度AAC和重度AAC的EH患者CHD患病率风险分别比无AAC患者高2.06(95%置信区间,1.23 - 3.45)倍和2.18(1.09 - 5.25)倍。RCS曲线表明AAC与CHD之间存在剂量反应线性关系。

结论

这些发现突出表明,在EH患者中,AAC严重程度越高,CHD患病率风险越高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be97/11122146/bc13606f9858/jcdd-11-00143-g001.jpg

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