Ren Zhongyuan, Yang Haotian, Zhu Wenqing, Han Jun, Yu Shikai, Zhao Song, Meng Weilun, Xu Yawei, Zhao Yifan, Zhang Yi
Heart Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
School of Medicine, Tongji University, Shanghai, 200092, China.
Clin Hypertens. 2024 Nov 1;30(1):31. doi: 10.1186/s40885-024-00288-3.
This study aimed to investigate the prognostic value of age and blood pressure stratified healthy vascular aging (HVA) defined in the North Shanghai Study (NSS), and illustrate its relationship with organ damage (OD).
This study enrolled 3590 community-dwelling elderly Chinese aged over 65 years and finally 3234 participants were included. 3230 individuals were included in the final analysis, with 4 participants lost to follow-up. NSS HVA was defined as low carotid-femoral pulse wave velocity (PWV) which had a higher cutoff value with advanced age and level of blood pressure. OD was thoroughly assessed and classified into vascular, cardiac and renal OD. Primary endpoints were major adverse cerebrocardiovascular events (MACCE) and all-cause mortality.
Nine hundred seventy-eight participants out of 3234 participants (43.1%) were identified as having NSS HVA. The NSS HVA group exhibited a younger age, lower blood pressure levels, lower body mass index, and milder OD compared to the non-NSS HVA group. Over follow-up of 5.7 ± 1.8 years, 332 MACCE (1.82 per 100 person-year) and 212 all-cause deaths (1.14 per 100 person -year) occurred. NSS HVA was associated with a reduced risk of MACCE (HR [95% CI] = 0.585, 0.454-0.754) and all-cause death (HR [95%CI] = 0.608 [0.445, 0.832]), especially in those subgroups without clinical diagnosed cardiovascular disease (CVD) or diabetes mellitus but with at least one type of OD. Moreover, NSS HVA exhibited improved prognostic value for MACCE, all-cause death and CVD death compared to other definitions of HVA.
Age and blood pressure stratified NSS HVA could serve as an improved indicator against serious adverse events in the community-dwelling elderly Chinese.
Prognosis in the Elderly Chinese: The Northern Shanghai Study (NSS), NCT02368938, https://clinicaltrials.gov/study/NCT02368938?cond=NCT02368938&rank=1 .
本研究旨在探讨在上海北部研究（NSS）中定义的年龄和血压分层的健康血管老化（HVA）的预后价值，并阐明其与器官损害（OD）的关系。
本研究纳入了3590名65岁以上居住在社区的中国老年人，最终纳入3234名参与者。最终分析纳入3230名个体，4名参与者失访。NSS HVA定义为低颈动脉-股动脉脉搏波速度（PWV），其临界值随年龄增长和血压水平升高而升高。对OD进行了全面评估，并分为血管性、心脏性和肾性OD。主要终点是主要不良心脑血管事件（MACCE）和全因死亡率。
3234名参与者中有978名（43.1%）被确定为患有NSS HVA。与非NSS HVA组相比，NSS HVA组年龄更小、血压水平更低、体重指数更低，OD更轻。在5.7±1.8年的随访中，发生了332例MACCE（每100人年1.82例）和212例全因死亡（每100人年1.14例）。NSS HVA与MACCE风险降低（HR[95%CI]=0.585，0.454-0.754）和全因死亡风险降低（HR[95%CI]=0.608[0.445，0.832]）相关，尤其是在那些没有临床诊断心血管疾病（CVD）或糖尿病但至少有一种OD类型的亚组中。此外，与其他HVA定义相比，NSS HVA对MACCE、全因死亡和CVD死亡具有更好的预后价值。
年龄和血压分层的NSS HVA可作为中国社区居住老年人严重不良事件的改良指标。
中国老年人的预后：上海北部研究（NSS），NCT02368938，https://clinicaltrials.gov/study/NCT02368938?cond=NCT02368938&rank=1 。
