外周血压和中心动脉压的差异性研究

Study on the difference between peripheral blood pressure and central arterial pressure

目的中心动脉压比外周动脉压对心血管终点事件具有更好的预测价值,本研究的目的是分析高血压人群中心动脉压和肱动脉压的差异。方法研究对象为640名(46岁±8岁)无明显心血管病体检者,根据肱动脉压分为高血压组和非高血压组,计算两组人群的中心动脉压和肱动脉压的脉压比值,来描述两动脉压的差异,通过逐步多变量线性回归分析确定脉压比值的独立影响因子。结果年龄和高血压是脉压比值的独立影响因子。随着年龄的增加,脉压比值不断增大。与非高血压人群相比,高血压人群脉压比值显著增加(P<0.05)。对研究人群按照肱动脉收缩压进行风险等级划分,不同风险等级之间中心动脉收缩压的分布存在大量的重叠。结论中心动脉压不能由肱动脉压完全代替,准确评估中心动脉压可能提高对心血管事件的识别,完善对高血压人群的健康管理。

Objective Recent evidence suggests that central arterial pressure is more strongly related to futher cardiovascular end point event than brachial arterial pressure.The aim of the present study is to analyze the difference between the central arterial pressure and brachial arterial pressure in hypertensive population.Methods Subjects were consisted of 640 individuals(age range:22 to 65 years,46 years±8 years)without significant cardiovascular disease.The subjects were divided into hypertensive and nonhypertensive group according to the brachial arterial pressure.The ratio between central and brachial pulse pressure(P P ratio)was calculated to describe the difference between the two arterial pressures in the two groups.Stepwise multiple liner regression analyses were also performed to determine the factors influencing PP ratio.Results Age and hypertension were independent predictors of PP ratio.PP ratio was increasing with age.Compared with nonhypertensive group,hypertensive group showed higher PP ratio(P<0.05).There were extensive overlaps in central systolic blood pressure between categories,without any overlaps between brachial systolic blood pressures.Conclusions Central arterial pressure can not be completely replaced by brachial arterial pressure.Accurate assessment of central arterial pressure may improve the identification of cardiovascular risk,and improve the health management of hypertensive population.