非糖尿正常血压人群升主动脉扩张的危险因素是什么？中国的一项横断面研究。

What are the risk factors for ascending aorta dilatation in the non-diabetic normotensive population? A cross-sectional study in China.

机构信息

Cardiovascular Department, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

Cardiovascular Department, West China Hospital of Sichuan University, Chengdu, Sichuan, China

出版信息

BMJ Open. 2024 Nov 13;14(11):e080194. doi: 10.1136/bmjopen-2023-080194.

DOI:10.1136/bmjopen-2023-080194

PMID:39537567

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11574436/

Abstract

OBJECTIVES

Ascending aorta dilatation (AAD) has been suggested as a surrogate marker for vascular organ damage in the hypertensive population. However, limited data are available on AAD in normotensive individuals. This study aims to preliminarily explore the correlation between ascending aorta (AAO) and other established clinically significant target organ damage parameters and to investigate the possible risk factors of AAD in the non-diabetic normotensive individuals.

DESIGN

Our study has a cross-sectional design.

SETTING

All participants were recruited from the inpatient and outpatient departments of our hospital.

PARTICIPANTS

We recruited 634 normotensive participants (52.26±16.22 years, 39.43% male) who underwent both ambulatory blood pressure monitoring (ABPM) and echocardiography. The whole study population was divided into AAD and non-AAD groups according to age-gender-specific criteria. The baseline mean blood pressure (BP) of the two groups was 126.92/77.72 and 124.16/77.61 mm Hg, respectively.

PRIMARY AND SECONDARY OUTCOME MEASURES

The relationship between AAO and other acknowledged cardiac damage indicators, as well as the associations of AAD with ABPM indexes in the non-diabetic normotensive individuals.

RESULTS

We observed that AAO exhibited a significant correlation with left ventricular mass index (β=1.905, p<0.001), e' (β=-0.324, p<0.001) and E/e' (β=0.221, p<0.001). Among all the ABPM indexes, only those related to diastolic BP (DBP), specifically 24-hour DBP (OR=1.056, 95% CI 1.004 to 1.110, p<0.05) and night-time DBP (OR=1.071, 95% CI 1.011 to 1.134, p<0.05), were associated with AAD after adjustment for age, gender and other confounders. Furthermore, in the multivariate forward logistic regression analysis, night-time DBP was most strongly associated with AAD (OR=1.064, 95% CI 1.008 to 1.124, p<0.05).

CONCLUSIONS

We found that AAO was correlated with alterations in other acknowledged cardiac parameters, both structural and functional, in non-diabetic normotensive individuals, indicating AAD may be significant in these individuals. Notably, DBP, especially night-time DBP, showed a more significant correlation with AAD.

TRIAL REGISTRATION NUMBER

ChiCTR2000030677.

摘要

目的

升主动脉扩张（AAD）已被认为是高血压人群血管器官损伤的替代标志物。然而，关于正常血压个体的 AAD 的数据有限。本研究旨在初步探讨升主动脉（AAO）与其他已建立的临床显著靶器官损伤参数之间的相关性，并探讨非糖尿病正常血压个体中 AAD 的可能危险因素。

设计

我们的研究采用横断面设计。

地点

所有参与者均来自我院住院和门诊部门。

参与者

我们招募了 634 名正常血压参与者（52.26±16.22 岁，39.43%男性），他们均接受了动态血压监测（ABPM）和超声心动图检查。根据年龄和性别特异性标准，将整个研究人群分为 AAD 和非 AAD 组。两组的基础平均血压（BP）分别为 126.92/77.72 和 124.16/77.61mmHg。

主要和次要结局指标

AAO 与其他公认的心脏损伤指标之间的关系，以及非糖尿病正常血压个体中 AAD 与 ABPM 指标的相关性。

结果

我们发现 AAO 与左心室质量指数（β=1.905，p<0.001）、e'（β=-0.324，p<0.001）和 E/e'（β=0.221，p<0.001）呈显著相关。在所有 ABPM 指标中，只有与舒张压（DBP）相关的指标，特别是 24 小时 DBP（OR=1.056，95%CI 1.004 至 1.110，p<0.05）和夜间 DBP（OR=1.071，95%CI 1.011 至 1.134，p<0.05）与 AAD 相关，在调整年龄、性别和其他混杂因素后。此外，在多元向前逻辑回归分析中，夜间 DBP 与 AAD 的相关性最强（OR=1.064，95%CI 1.008 至 1.124，p<0.05）。