Sutton-Tyrrell K, Alcorn H G, Wolfson S K, Kelsey S F, Kuller L H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261.
Stroke. 1993 Mar;24(3):355-61. doi: 10.1161/01.str.24.3.355.
This study was designed to determine the prevalence of carotid stenosis and atherosclerosis in older adults with and without isolated systolic hypertension and to determine risk factors for carotid artery disease in these two groups.
Duplex scans were performed on 187 participants of the Systolic Hypertension in the Elderly Program and on 187 normotensive control subjects. Doppler measures of blood flow velocity were used to determine the prevalence of internal carotid artery stenosis.
Carotid stenosis was found in 25% of hypertensive participants but in only 7% of normotensive participants (p < 0.001). Among hypertensive participants, carotid stenosis was correlated with lower diastolic blood pressure (p = 0.022). In multivariate analysis, systolic blood pressure of > or = 160 mm Hg was the strongest predictor of carotid stenosis. Other variables independently related to stenosis were diastolic blood pressure of < 75 mm Hg (p = 0.001), alcohol use (p = 0.005), heart rate of > or = 80 beats per minute (p = 0.013), smoking (p = 0.034), high concentration of apoprotein B (p = 0.001), and low concentration of high density lipoprotein cholesterol (borderline significant, p = 0.069). Among hypertensive participants, the strongest predictor of carotid stenosis was low diastolic blood pressure. This relation persisted even after taking into account differences in pulse pressure.
Isolated systolic hypertension is strongly correlated with carotid stenosis, and among those with isolated systolic hypertension low diastolic blood pressure is a marker for carotid stenosis.
本研究旨在确定患有和未患有单纯收缩期高血压的老年人中颈动脉狭窄和动脉粥样硬化的患病率，并确定这两组人群中颈动脉疾病的危险因素。
对老年收缩期高血压计划的187名参与者和187名血压正常的对照者进行了双功扫描。使用多普勒血流速度测量来确定颈内动脉狭窄的患病率。
在高血压参与者中发现25%存在颈动脉狭窄，而在血压正常的参与者中仅为7%（p<0.001）。在高血压参与者中，颈动脉狭窄与较低的舒张压相关（p = 0.022）。在多变量分析中，收缩压≥160 mmHg是颈动脉狭窄的最强预测因素。与狭窄独立相关的其他变量包括舒张压<75 mmHg（p = 0.001）、饮酒（p = 0.005）、心率≥80次/分钟（p = 0.013）、吸烟（p = 0.034）、载脂蛋白B浓度高（p = 0.001）以及高密度脂蛋白胆固醇浓度低（临界显著，p = 0.069）。在高血压参与者中，颈动脉狭窄的最强预测因素是低舒张压。即使考虑到脉压差异，这种关系仍然存在。
单纯收缩期高血压与颈动脉狭窄密切相关，在单纯收缩期高血压患者中，低舒张压是颈动脉狭窄的一个标志。
