Dorogovtsev Victor N, Yankevich Dmitry S, Tsareva Valentina M, Punin Denis A, Borisov Ilya V, Dekhnich Natalya N, Grechko Andrey V
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia.
Smolensk State Medical University, 214019 Smolensk, Russia.
Diagnostics (Basel). 2025 Feb 20;15(5):517. doi: 10.3390/diagnostics15050517.
Early detection of increased vascular stiffness in young populations may facilitate the development of more effective strategies for the primary prevention of arterial hypertension and other age-related cardiovascular diseases. To examine gender differences in orthostatic increases in vascular stiffness during the head-up tilt test (HUTT), standardized by hydrostatic column height. A total of 133 healthy adults aged 18-20 years (93 females and 40 males) were evaluated. Blood pressure and pulse wave velocity at the brachial-ankle artery site (baPWV) were measured using an ABI system 100 PWV multichannel sphygmomanometer. Orthostatic changes in arterial stiffness were assessed during a head-up tilt test (HUTT) using the Luanda protocol, which standardizes hydrostatic column height. The functional reserve coefficient (FRC) of orthostatic circulatory regulation was introduced as a measure of adaptive capacity: FRC = ΔbaPWV/baPWVb. This coefficient accounts for both structural (baPWVb) and functional (ΔbaPWV = baPWVt - baPWVb) components influencing cardiovascular system adaptation, which exhibit multidirectional changes with age. Baseline baPWV (baPWVb) values in the horizontal position showed no significant differences between genders and were within normal age ranges. However, baPWV values in the upright HUTT position (baPWVt) were significantly higher in men ( = 0.0007). Dynamic biomarkers of vascular reserve, including ΔbaPWV and FRC, were also significantly elevated in men ( = 0.0009 and = 0.0064, respectively). While baseline baPWVb values were comparable between genders, dynamic biomarkers of vascular reserve, such as ΔbaPWV and FRC, were significantly higher in men. Prospective studies are needed to establish optimal reference values for these dynamic biomarkers, enabling the assessment of individual trends in vascular aging and evaluating the effects of treatment, lifestyle modifications, and other preventive measures on vascular health.
早期检测年轻人群中血管僵硬度增加,可能有助于制定更有效的策略,以对动脉高血压和其他与年龄相关的心血管疾病进行一级预防。为了研究在通过静水压力柱高度标准化的头高位倾斜试验(HUTT)期间,血管僵硬度体位性增加的性别差异。共评估了133名年龄在18 - 20岁的健康成年人(93名女性和40名男性)。使用ABI系统100 PWV多通道血压计测量肱踝动脉部位(baPWV)的血压和脉搏波速度。在头高位倾斜试验(HUTT)期间,采用罗安达方案评估动脉僵硬度的体位性变化,该方案对静水压力柱高度进行了标准化。引入体位性循环调节功能储备系数(FRC)作为适应能力的度量:FRC = ΔbaPWV/baPWVb。该系数考虑了影响心血管系统适应的结构成分(baPWVb)和功能成分(ΔbaPWV = baPWVt - baPWVb),它们随年龄呈现多方向变化。水平位的基线baPWV(baPWVb)值在性别之间无显著差异,且在正常年龄范围内。然而,男性在直立HUTT位的baPWV值(baPWVt)显著更高( = 0.0007)。包括ΔbaPWV和FRC在内的血管储备动态生物标志物在男性中也显著升高(分别为 = 0.0009和 = 0.0064)。虽然基线baPWVb值在性别之间具有可比性,但血管储备的动态生物标志物,如ΔbaPWV和FRC,在男性中显著更高。需要进行前瞻性研究以建立这些动态生物标志物的最佳参考值,从而能够评估血管老化的个体趋势,并评估治疗、生活方式改变和其他预防措施对血管健康的影响。