正常高值血压人群血糖和血脂水平及对脉搏波的影响

Impact of blood glucose and blood lipids on pulse-wave velocity in population with high value of normal blood pressure

目的观察正常高值血压者心血管病（CVD）危险因素及脉搏波（pulse—wavevelocity，Pwv），评价正常高值血压者动脉弹性的改变，并探讨动脉弹性下降与CVD危险因素之间的联系。方法进行横断面调查，40—75岁人群6600例，获得完整资料的6010例，比较分析正常血压（n=1134，18．9％）、正常高值血压（n=2225，37．0％）及高血压人群（n=2651，44．1％，标化率为44．4％）的CVD危险因素及Pwv的情况，了解与Pwv的相关性。结果年龄、体质指数（BMI）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）、心率、空腹血糖（FPG）及餐后2h血糖（2hPG）在正常血压、正常高值血压及高血压组逐渐增高，高密度脂蛋白胆固醇（HDL—C）逐渐降低，组问差异均有统计学意义（p〈O．01）；收缩压（SBP）和舒张压（DBP）与肱踝脉搏波传导速度（baPWV）存在直线相关（F=2244．62，P=0．001）。PwV的多因素logistic回归分析显示，SBP和DBP是Pwv的独立相关危险因素。结论正常高值血压与PwV改变密切相关，是动脉粥样硬化的独立危险因素，对正常高值血压人群采用生活方式干预以降低动脉硬化的危险，具有重要的公共健康意义。

Objective To observe the risk factors of cardiovascular disease （CVD）, pulse-wave velocity （PWV） and the change of artery elasticity in residents with the high value of normal blood pressure （BP）, and to explore the relationship between decreased artery elasticity and CVD risk factors. Methods A cross-sectional investigation of 6 600 residents （40-75 years old） was performed. The 6 010 residents with complete data were divided into normal BP group （A group, n=l 134, 15.9%）, group with high value of normal BP （B group, n=2 225, 37.0%） and hypertension group （C group, n=2 651, 44.1%）. The relationship between CVD risk factors and PWV were analyzed. Results Ages, body mass index （BMI）, total cholesterol （TC）, triglyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, heart rate （HR）, fasting plasma glucose （FPG） and 2 h-postprandial plasma glucose （2 h PG） in C group were higher than those in B group, which were higher than those in A group; but the high-density lipoprotein cholesterol （HDL-C） in C group was lower than that in B group, which was lower than that in A group （P〈0.01）. There was a linear correlation among systolic BP（SBP）, diastolic BP（DBP） and brachial-ankle PWV （baPWV） （ F=2 244.62, P=0.001 ）. The multiple factor logistic regression analysis showed that SBP and DBP were the independent risk factors of baPWV. Conclusion The high value of normal BP are closely associated with baPWV which is a risk factor of atherosclerosis （AS）. The lifestyle intervention for population with high value of normal BP should be conducted to reduce the risk of AS.