单纯收缩期高血压病人年龄与血管内皮功能对大动脉僵硬度的影响

Impact of Age and Vascular Endothelial Function on Arterial Stiffness in Isolated Systolic Hypertersion

目的探讨单纯收缩期高血压(ISH)患者大动脉僵硬度与年龄、血管内皮功能之间的关系。方法对老年单纯收缩期高血压病人71例,进行大动脉僵硬度(主动脉脉搏波传导速度,baPWV)和内皮依赖性血管舒张功能(FMD)检测。同期年龄配对的健康老年人30例和健康中年人50例作为对照组。结果老年单纯收缩期高血压组、老年健康组、中年健康组 baPWV 依次减慢[老年 ISH:(2459.2±436.8)比老年健康:(2097.2±315.7)比中年健康:(1619.7±214.2)cm/s,P<0.01或<0.05),而 FMD 则依次增大(老年 ISH:6.2±2.2比老年健康:9.8±2.5比中年健康:14.4±1.9,P<0.05或<0.01)。在老年单纯收缩期高血压组中,baPWV 与 FMD呈显著性负相关、与收缩压(SBP)、脉压(PP)呈显著性正相关。多元逐步回归分析证明:年龄、FMD、SBP、PP 是大动脉僵硬度的危险因素。结论在老年单纯收缩期高血压病人中增龄与 FMD 失调明显增加了大动脉僵硬度,因此,在控制 ISH 的同时,改善 FMD 可以降低大动脉僵硬度,从而进一步降低心血管事件的风险。

Objective To investigate the impact of aging and vascular endothelial function on arterial stiffness in patients with isolated systolic hypertension. Methods Patients with isolated systolic hypertension （ISH, n=75） age-matched healthy subjects（n=30） and young healthy subjects（n=50） were submitted to determination of aortic pulse wave velocity （baPWV） and vascular endothelial function evaluated by flow-mediated dila- tion（FMD）. Results baPWV was progresively decreased（ISH： 2459.2 ±436.8 vs elderly heahhy： 2097. 2 ± 315.7 vs young healthy： 1619.7 ± 214.2 cm/s, P〈0.01 or 〈0.05）, while FMD was progressively increased （ISH： 6. 2±2.2 vs elderly healthy： 9.8±2.5 vs young healthy： 14.4±1.9, P〈0.05 or 〈0.01） from ISH to elderly healthy subjects to young healthy subject in a rank manner, baPWV was correlated inversely with FMD. Multiple linear regression analysisshowed aging, FMD, systolic pressure, and pulse pressure were risk factors predioposed for arterial stiffness. Conclusion Our results suggest that endothelial dysfunction and aging both contribute to increased arterial stiffness in patients with isolated systolic hypertension. Improvment of endothelial function and large arterial stiffness are both important in reducing cardiovascular events.