Xing Changyang, Xu Lei, Li Fan, Xie Xiujing, Guan Xiangping, Zhan Xiaojun, Chen Wu, Yang Hengli, Wang Xiangzhu, Wang Yingli, Li Jinsong, Zhou Qi, Mu Yuming, Zhou Qing, Ding Yunchuan, Zheng Yu, Wu Yu, Sun Xiaofeng, Li Hua, Zhang Chaoxue, Zhao Cheng, Qiu Shaodong, Yan Guozhen, Yang Hong, Mao Yinjuan, Zhan Weiwei, Ma Chunyan, Gu Ying, Xie Mingxing, Jiang Tianan, Yuan Lijun
Department of Ultrasound Medicine, Tangdu Hospital, Air Force Medical University.
Department of Ultrasound, Xi'an Hospital of Traditional Chinese Medicine.
J Hypertens. 2025 Apr 1;43(4):615-622. doi: 10.1097/HJH.0000000000003943. Epub 2024 Dec 9.
The arterial stiffening is attributed to the intrinsic structural stiffening and/or load-dependent stiffening by increased blood pressure (BP). The respective lifetime alterations and major determinants of the two components with normal aging are not clear.
A total of 3053 healthy adults (1922 women) aged 18-79 years were enrolled. The carotid intima-media thickness, diameter, and local BPs were automatically determined by the radio frequency ultrasound system. The Peterson and Young elastic moduli were then calculated to represent total arterial stiffness. Structural stiffness was recalculated at a reference BP of 120/80 mmHg with established models. Load-dependent stiffness was the difference between total and structural stiffness.
Both structural and load-dependent stiffness increased with aging, with much larger changes in the structural components. The age-related increasing rates were higher in women for the structural stiffness than men ( P < 0.05), but similar for the load-dependent stiffness. The clinical characteristics and arterial stiffness were widely correlated, but most correlations were quite weak ( r < 0.3) other than BPs. Multiple regression analyses adjusted for sex, age and other clinical correlates showed that structural stiffness increased with pulse pressure (PP) and load-dependent stiffness increased with mean arterial pressure (MAP), respectively.
The age-related arterial stiffening is mainly caused by the intrinsic structural stiffening, which demonstrated significant age-sex interaction. BPs were the major clinical determinants of arterial stiffness, with PP and MAP associated with different arterial stiffness components. The differentiation of the structural and load-dependent arterial stiffness should be highlighted for the optimal vascular health management.
动脉僵硬度归因于内在结构僵硬度和/或因血压（BP）升高导致的负荷依赖性僵硬度。正常衰老过程中这两种成分各自的终生变化及主要决定因素尚不清楚。
共纳入3053名年龄在18 - 79岁的健康成年人（1922名女性）。通过射频超声系统自动测定颈动脉内膜中层厚度、直径及局部血压。然后计算彼得森弹性模量和杨氏弹性模量以代表总动脉僵硬度。使用既定模型在120/80 mmHg的参考血压下重新计算结构僵硬度。负荷依赖性僵硬度为总僵硬度与结构僵硬度之差。
结构僵硬度和负荷依赖性僵硬度均随年龄增长而增加，结构成分变化更大。女性结构僵硬度随年龄增长的速率高于男性（P < 0.05），但负荷依赖性僵硬度相似。临床特征与动脉僵硬度广泛相关，但除血压外，大多数相关性较弱（r < 0.3）。经性别、年龄及其他临床相关因素校正的多元回归分析表明，结构僵硬度分别随脉压（PP）增加，负荷依赖性僵硬度随平均动脉压（MAP）增加。
与年龄相关的动脉僵硬度主要由内在结构僵硬度引起，其显示出显著的年龄 - 性别交互作用。血压是动脉僵硬度的主要临床决定因素，脉压和平均动脉压分别与不同的动脉僵硬度成分相关。为实现最佳的血管健康管理，应突出结构和负荷依赖性动脉僵硬度的区分。
