Gosse Philippe, Doublet Julien, Gaudissard Julie, Debois Lauryne, Cremer Antoine
Hypertension unit, University hospital of Bordeaux, Bordeaux, France.
Hypertens Res. 2024 Sep;47(9):2489-2494. doi: 10.1038/s41440-024-01799-0. Epub 2024 Jul 16.
Arterial stiffness is an independent predictor of cardiovascular events in different populations. Destiffening appears to be possible through the control of the main cardiovascular risk factors, with however important individual variations. There are so far too few data available on the prognostic importance of changes in arterial stiffness. We tested the consequences of changes in arterial stiffness assessed with the QKD method on the incidence of cardiovascular events in a cohort of hypertensive patients. The change of QKD was calculated as the difference between baseline and last follow-up value. Patients were classified as group 0 with stable or increased QKD and group 1 with decreased QKD (increased arterial stiffness). The prognostic of these two groups was analysed with a Cox model including age, baseline QKD, 24 h SBP (baseline and change), delay between first and last recording, sex, diabetes, smoking, and hypercholesterolemia. We included 555 essential hypertensive patients with 24 h ambulatory measurement of BP and QKD at baseline and follow-up. The follow-up period was 12.28 ± 7.38 years with an average time between baseline and last recording of 8.86 ± 6.48 years. 94 cardiovascular events occurred. The group with increased arterial stiffness shows the double risk of occurrence of cardiovascular event than the group with stable or reduced arterial stiffness independently of other factors including changes in 24 h SBP.
动脉僵硬度是不同人群心血管事件的独立预测指标。通过控制主要心血管危险因素似乎有可能减轻动脉僵硬度,不过存在重要的个体差异。目前关于动脉僵硬度变化的预后重要性的数据仍然太少。我们在一组高血压患者中测试了用QKD方法评估的动脉僵硬度变化对心血管事件发生率的影响。QKD的变化计算为基线值与最后随访值之间的差值。患者被分为QKD稳定或升高的0组和QKD降低(动脉僵硬度增加)的1组。使用Cox模型分析这两组的预后,该模型包括年龄、基线QKD、24小时收缩压(基线值和变化值)、首次记录与最后记录之间的时间间隔、性别、糖尿病、吸烟和高胆固醇血症。我们纳入了555例原发性高血压患者,他们在基线和随访时进行了24小时动态血压测量和QKD测量。随访期为12.28±7.38年,基线与最后记录之间的平均时间为8.86±6.48年。发生了94例心血管事件。与动脉僵硬度稳定或降低的组相比,动脉僵硬度增加的组发生心血管事件的风险高出一倍,这与包括24小时收缩压变化在内的其他因素无关。