Author Affiliations: Clinical Exercise Physiology Human Performance Laboratory, Ball State University, Muncie, Indiana (Dr Carlini, Mss Stump and Lumadue, and Drs Harber and Fleenor); and Physiology Department, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, Tennessee (Dr Fleenor).
J Cardiopulm Rehabil Prev. 2024 Jul 1;44(4):289-294. doi: 10.1097/HCR.0000000000000869. Epub 2024 Jun 17.
The objective of this study was to determine the relationship between aortic stiffening and brachial and central ambulatory blood pressure (AMBP) in a nonclinical sample of middle-aged and older adults (MA/O). We hypothesized aortic stiffness would be positively associated with 24-hr, daytime, and nighttime brachial and central AMBP.
Fifty-one participants aged ≥50 yr (21 males and 30 females, mean age 63.4 ± 9.0 yr) with a body mass index <35 kg/m 2 who also had a resting brachial blood pressure (BP) <160/100 mmHg with or without BP medications were recruited for this cross-sectional analysis. All participants underwent measures of aortic stiffness (carotid-femoral pulse wave velocity [cfPWV]) and 24-hr AMBP monitoring. Bivariate correlations assessed the relationship between cfPWV, brachial, and central AMBP. Partial correlations were used to independently adjust for traditional cardiovascular disease (CVD) risk factors including age, sex, waist circumference, glucose, and augmentation index normalized to heart rate 75 bpm, a surrogate measure of arterial stiffness, and in a multivariable combined model.
Nighttime brachial systolic BP ( r = 0.31) and central systolic BP ( r = 0.30) were correlated with cfPWV in the multivariable combined model ( P ≤ .05). Nighttime brachial pulse pressure and central pulse pressure were correlated with cfPWV after independently adjusting for all CVD risk factors ( P ≤ .05, all) but not when combined in the multivariable model ( P > .05).
Higher nighttime brachial and central AMBP with older age are related, in part, to greater aortic stiffening. Therefore, interventions to lower or prevent aortic stiffening may also lower nighttime BP in MA/O adults to lower CVD risk.
本研究旨在确定非临床中老年人群（MA/O）主动脉僵硬度与臂部和中心动态血压（AMBP）之间的关系。我们假设主动脉僵硬度与 24 小时、日间和夜间臂部和中心 AMBP 呈正相关。
本横断面分析共招募了 51 名年龄≥50 岁（21 名男性和 30 名女性，平均年龄 63.4±9.0 岁）、体重指数（BMI）<35kg/m 2 且静息臂部血压（BP）<160/100mmHg 且无论是否服用降压药物的患者。所有参与者均接受了主动脉僵硬度（颈股脉搏波速度[cfPWV]）和 24 小时 AMBP 监测。采用双变量相关分析评估 cfPWV 与臂部和中心 AMBP 之间的关系。采用偏相关分析分别独立校正传统心血管疾病（CVD）危险因素，包括年龄、性别、腰围、血糖和心率 75bpm 归一化的增强指数，这是动脉僵硬度的替代指标，并在多变量联合模型中进行分析。
在多变量联合模型中，夜间臂部收缩压（ r = 0.31）和中心收缩压（ r = 0.30）与 cfPWV 相关（ P ≤ 0.05）。夜间臂部脉压和中心脉压与 cfPWV 相关，在独立校正所有 CVD 危险因素后（ P ≤ 0.05，均），但在多变量模型中合并时则无相关性（ P > 0.05）。
随着年龄的增长，夜间臂部和中心 AMBP 升高与主动脉僵硬度增加部分相关。因此，降低或预防主动脉僵硬度的干预措施可能也会降低 MA/O 成年人的夜间血压，从而降低 CVD 风险。
