Zhang Sijin, Ma Mingjie, Li Ping, Yao Siyu, Wang Chi, Wang Xiaojian, He Kunlun, Xue Hao
School of Medcine, Nankai University, Tianjin, China.
Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Clin Hypertens (Greenwich). 2025 Jun;27(6):e70086. doi: 10.1111/jch.70086.
Bone morphogenetic protein 9 (BMP9) plays an important role in vascular development and stability. However, the association between circulating BMP9 levels and arterial stiffness (AS) in hypertensive patients is not yet clear. This study enrolled 305 hospitalized patients with hypertension. Brachial-ankle pulse wave velocity (baPWV) was measured, with values ≥1800 cm/s indicating AS. Clinical characteristics and laboratory parameters were collected during hospitalization. Circulating BMP9 levels were measured with an ELISA kit. Multivariable linear regression and stepwise logistic regression analysis were used to assess the relationship between BMP9 and baPWV. A nomogram was constructed to predict AS in hypertensive patients and internally validated using the bootstrap method. Among 305 patients, 97 were diagnosed with AS. Multivariable linear regression analysis revealed that BMP9 was positively correlated with baPWV in hypertensive patients (β = 0.471, p < 0.001). Multivariate logistic stepwise regression analysis showed that age ≥ 60 years old, diabetes mellitus, SBP ≥ 140 mmHg, and higher BMP9 levels were the independent risk factors for hypertensive patients with AS. A nomogram combining these factors showed strong predictive performance (AUC: 0.804, 95% CI: 0.7503-0.8567). The calibration plot performed a good adaptability between prediction and observation (χ = 6.60, p = 0.359) and the decision curve analysis (DCA) demonstrated the acceptable clinical utility. The addition of BMP9 to the traditional risk model had an incremental effect on the predictive value for AS (0.765 vs. 0.804, p < 0.01). The elevation of BMP9 is strongly related to AS in hypertensive patients. BMP9 may be a biomarker of AS in hypertension.
骨形态发生蛋白9（BMP9）在血管发育和稳定性中起重要作用。然而，高血压患者循环BMP9水平与动脉僵硬度（AS）之间的关联尚不清楚。本研究纳入了305例住院高血压患者。测量肱踝脉搏波速度（baPWV），baPWV≥1800 cm/s表明存在AS。住院期间收集临床特征和实验室参数。使用ELISA试剂盒测量循环BMP9水平。采用多变量线性回归和逐步逻辑回归分析评估BMP9与baPWV之间的关系。构建了一个列线图来预测高血压患者的AS，并使用自助法进行内部验证。在305例患者中，97例被诊断为AS。多变量线性回归分析显示，高血压患者中BMP9与baPWV呈正相关（β = 0.471，p < 0.001）。多因素逻辑逐步回归分析表明，年龄≥60岁、糖尿病、收缩压≥140 mmHg以及较高的BMP9水平是高血压合并AS患者的独立危险因素。结合这些因素的列线图显示出较强的预测性能（AUC：0.804，95% CI：0.7503 - 0.8567）。校准图在预测和观察之间表现出良好的适应性（χ = 6.60，p = 0.359），决策曲线分析（DCA）表明具有可接受的临床实用性。将BMP9添加到传统风险模型中对AS的预测价值有增量作用（0.765对0.804，p < 0.01）。BMP9升高与高血压患者的AS密切相关。BMP9可能是高血压中AS的生物标志物。
