中老年人群随诊间收缩压变异性与臂踝动脉脉搏波传导速度的关系

The relationship between visit-to-visit systolic blood pressure variability and brachial-ankle pulse wave velocity in middle-aged and elderly populations

目的分析中老年人群随诊间收缩压变异性与臂踝动脉脉搏波传导速度(baPWV)的关系。方法抽取唐山开滦(集团)有限责任公司在职及离退休职工中年龄≥40～<80岁、既往无脑卒中、短暂性脑缺血发作、心肌梗死者共4383例为调查对象,进行统一问卷调查、血液生化及动脉硬化监测。计算2006、2008、2010年度体检时测得的3次血压值的均值,以每年度3次血压均值的标准差为随诊间血压变异性(BPV)。将研究对象分为高baPWV组(baPWV≥1400cm/s)和低baPWV组(baPWV<1400cm/s)。用Logistic回归分析随诊间收缩压变异性与baPWV的关系。结果共有4383例(男性2636例,女性1747例)纳入统计分析。高baPWV组人群的年龄、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高敏C反应蛋白对数值及收缩压变异性均大于低baPWV组,高baPWV组高血压病史及用药史、糖尿病病史及用药史所占百分比均大于低baPWV组。多因素Logistic回归分析显示与收缩压变异性<5.8mmHg者比较,收缩压变异性9.6～13.7mmHg者出现baPWV≥1400cm/s的相对危险为1.28倍(95%CI1.02～1.59),收缩压变异性≥13.7mmHg者出现baPWV≥1400cm/s的相对危险为2.37倍(95%CI1.86～3.01)。结论中老年人群随诊间收缩压BPV与baPWV相关。

Objective To explore the relationship between visit-to-visit systolic blood pressure variability and brachial-ankle pulse wave velocity（baPWV） in middle-aged and elderly populations. Methods From June 2010 to June 2011, a total of 4383 workers of Tangshan Kailuan Group aged 40-80, without stroke, transient ischemic attack and myocardial infarction were selected to receive the surveys, including unified questionnaire, blood biochemistry measurement, and brachial-ankle pulse wave velocity detection. The blood pressure of each worker was measured for three times respectively in 2006, 2008 and 2010, and the average values of each year were calculated. The blood pressui＇e variability（BPV） was defined as standard deviation of three average blood pressure values. The subjects were devided into high baPWV group （baPWV≥1400 cm/s） and low baPWV group （baPWV〈 1400 cm/s）. Multivariate logistic regression analysis was used to analyze the relationship between the visit-to-visit systolic BPV and baPWV. Results A total of 4383 eligible participants were enrolled, including 2636 males and 1747 females. The age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein, logarithm of high-sensitivity C-reactive protein and the systolic BPV of the high baPWV group were significantly higher than those of low baPWV group. The percentage of hypertension, diabetes, and medicine in the high baPWV group were higher than those in low baPWV group. Multivariate logistic regression analysis showed that the relative risks of baPWV≥1400 cm/s in the subjects with BPV 9.6-13.7 and ≥13.7 mm Hg were respectively 1.28 （95% CI 1.02-1.59） and 2.37 （95% CI 1.86-3.01） times of that in the subjects with BPV less than 5.8 mm Hg. Conclusion baPWV is positively related to the visit-to-visit BPV in middle-aged and elderly populations.