Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Albuminuria as a marker of arterial stiffness in chronic kidney disease patients

AIM:To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease(CKD) stages 1-2,treated with renin angiotensin blockade agents plus other hypertensive drugs when needed.METHODS:One hundred fifteen patients [median age 52 years(68% males)] were consequently enrolled in the study.For each patient,we recorded gender,age,body mass index(BMI),peripheral systolic blood pressure(p SBP),peripheral diastolic blood pressure,peripheral pulse pressure,central systolic blood pressure(c SBP),central diastolic blood pressure(c DBP),central pulse pressure(c PP),hematocrit,hemoglobin,hs CRP,total cholesterol triglycerides,high-density lipoprotein-C,low-density lipoprotein-C,calcium,phosphorus,parathormone,and albumin,as well as 24 h urine albumin excretion.According to 24-h urine albumin collection,patients were then classified as those with moderately increased albuminuria(formerly called macroalbuminuria)(≤ 300 mg/d) and those with severely increased albuminuria(formerly called macroaluminuria(> 300 mg/d).We considered aortic stiffness(AS) indices [carotid femoral pulse wave velocity(PWVc-f) and augmentation index(AIx)] as primary outcomes ofthe study.We explored potential correlations between severely increased albuminuria and AS indices using a multiple linear regression model.RESULTS:Fifty-eight patients were included in the moderately increased albuminuria group and 57 in the severely increased albuminuria.Blood pressure measurements of the study population were 138 ± 14/82 ± 1.3 mm Hg(systolic/diastolic).There were no significant differences in age,sex,and BP measurements between the two groups.Patients with severely increased albuminuria had higher PWV and AIx than patients with moderately increased albuminuria(P < 0.02,P < 0.004,respectively).In addition these patients exhibited higher BMI(P < 0.03),hs CRP(P < 0.001),and fibrinogen levels(P < 0.02) compared to patients with moderately increased albuminuria.In multivariate linear regression analysis,severely increased albuminuria(β = 1.038,P < 0.010) p SBP(β = 0.028,P < 0.034) and Ht(β = 0.171,P = 0.001) remained independent determinants of the increased PWVc-f.Similarly,severely increased albuminuria(β = 4.385,P < 0.012),c SBP(β = 0.242,P < 0.001),c PP(β = 0.147,P < 0.01) and Ht levels(β = 0.591,P < 0.013) remained independent determinants of increased AIx.CONCLUSION:These findings demonstrate an independent association between AS indices and severely increased albuminuria in non-diabetic,hypertensive patients with CKD stages 1-2 treated with renin angiotensin aldosterone system blockers.

Association of Estimated Pulse Wave Velocity and the Dynamic Changes in Estimated Pulse Wave Velocity with All-Cause Mortality among Middle-Aged and Elderly Chinese

Objective We aimed to clarify the association between estimated pulse wave velocity(ePWV)and the changes in ePWV with all-cause mortality among middle-aged and elderly Chinese.Methods Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)from 2011-2018.The ePWV was calculated using an equation that included age and mean blood pressure(MBP).The ΔePWV was assessed as the difference in ePWV between the first two waves.Cox proportional hazard models were used to determine the association between ePWV and ΔePWV with all-cause mortality after adjustment for potential confounders.Results Of 13,116 participants during a median follow-up of 7.0 years,1,356 deaths occurred.An increased ePWV was independently associated with all-cause mortality.The hazard ratio[95% confidence interval(CI)]for participants from the 1^(st)-4^(th) quartile groups was 1.00,1.69(1.31-2.18),3.09(2.44-3.91),and 8.54(6.78-10.75),respectively.Each standard deviation(SD)increment of ePWV increased the risk of all-cause mortality by 132%.Furthermore,theΔePWV was significantly associated with a 1.28-fold(95%CI,1.18-1.38)risk of all-cause mortality per SD increment.Conclusion This cohort study provided novel evidence from a Chinese population that an increased ePWV or progression of the ePWV was independently associated with all-cause mortality,which highlighted the importance of mitigating ePWV progression in clinical practice.

Value of Pulsed Tissue Doppler Imaging in Predicting the Presence of Significant Coronary Artery Insufficiency

Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination;ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities;TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups;there was statisticallysignificant difference between Group I and Group II (P value;patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.

Association between serum homocysteine and arterial stiffness in elderly： a community-based study

BackgroundArterial 僵硬和 homocysteine 两个都是心血管的疾病的强大的预言者，特别在更旧的人口。以前的研究在人的题目与动脉的僵硬调查了 homocysteine 的协会，当时在 homocysteine 和动脉的僵硬在之间的关系老仍然是不定的。当前的学习在相关浆液在 780 个参加者 homocysteine 铺平到动脉的僵硬(颈动脉大腿骨的脉搏波浪速度( PWV )和颈动脉光线的 PWV )的二项措施的中国基于社区的老 persons.MethodsWe 与动脉的僵硬检验了 homocysteine 的协会(46.3%人，意味着年龄 71.9 年(变化 65-96 岁))从中国北京的二个社区。动脉的僵硬在二天 biomarker measurement.ResultsIn 多重调整模型，的时间以内被测量 homocysteine 层次强烈与颈动脉大腿骨的 PWV 被联系(标准化 &#x003b2；= 0.13， P &#x0003c；0.001 ) ，甚至在为心血管的疾病的古典风险因素的调整以后。当而有 homocysteine 的重要协会都没为颈动脉光线的 PWV.ConclusionsIn 中国老人，被观察，颈动脉大腿骨的 PWV 在正常上面被提高时，协会也更强壮浆液 homocysteine 层次与大动脉的僵硬的改变被联系。

Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

ObjectiveBoth 减少了 glomerular 过滤率(GFR ) 和动脉的僵硬为动脉粥样硬化被看作风险因素。以前的研究建议了在中央动脉的僵硬和 GFR 损失的度之间的协会。是否减少了 GFR 贡献外部动脉僵硬遗体争论。而且，从中国女人的一个队分析的数据是稀罕的。我们的目的是在中国 women.MethodsIn 探索在 GFR 和地区性的动脉的僵硬之间的关系这代表性的研究，我们随机与 GFR ≥ 招募了 1131 个成年女人居民；每 1.73 m， 2 从三个大社区在肾的疾病方程由饮食的中国修正估计了的 60 mL/min。中央、外部的动脉的僵硬被用一台验证自动设备测量颈动脉大腿骨的脉搏波浪速度(PWVcf ) 和颈动脉光线的 PWV (PWVcr ) 同时估计。当反映大、远侧的动脉的 properties.ResultsThe 平均数的一个合成参数估计学习组的 GFR (eGFR ) 是 100.05 ±，在心率 75 跳动 / 纪录(AIx-75 ) 的扩大索引被脉搏波浪分析测量；23.26 mL/minute 每 1.73 m 2 。题目被 eGFR 水平的 tertiles 组织。PWVcf 和从顶进行中的增加的 AIx-75 到底部 eGFR tertile，当 PWVcr 的价值是可比较的时。两 univariate 皮尔森关联和多重逐步的回归分析证明 eGFR 显著地与正常相关到 PWVcf，然而并非到 PWVcr 和 AIx-75.ConclusionsIn 汉语女人到温和地损害的肾的功能，减少的 eGFR 影响了使硬的 carotid-to-femoral 而非 carotid-to-radial。这提供对行为未来合理在这张人口调查动脉粥样硬化的预言者的未来的研究。

Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women

ObjectivesTo 在一个基于社区的队在动脉的僵硬与改变调查血浆 homocysteine 层次的协会。在这些协会的性差别是评估的 examined.MethodsWe 在到三的血浆 homocysteine 层次之间的关系脉管的功能测量[颈动脉大腿骨的脉搏波浪速度(CF-PWV ) ，颈动脉脚关节 PWV (CA-PWV ) 和心率改正了扩大索引(AI )] 在 1680 个参加者(吝啬的年龄：61.5 年；709 个男人， 971 个女人) 从北京的社区， China.ResultsIn univariate 分析，血浆 homocysteine 层次断然与 CF-PWV 有关(r = 0.211， P &#x0003c；0.0001 ) 并且 CA-PWV (r = 0.148， P &#x0003c；0.0001 ) 而相反地与 AI 联系了(r =&#x02212； 0.052， P = 0.016 ) 。在为 covariants 调整的多重线性回归模型，血浆 homocysteine 与 CF-PWV 有关断然留下了(标准化 &#x003b2；= 0.065， P = 0.007 ) 在全部的情况中。当男人和女人的组独立被检查时，血浆 homocysteine 仍然保持断然与 CF-PWV 联系了(标准化 &#x003b2；= 0.082， P = 0.023 ) 而在动脉的僵硬索引的 homocysteine 和任何东西之间的关系是，别在 women.ConclusionsIn 汉语人口在男人推进现在，血浆 homocysteine 层次独立地在男人然而并非在女人与大动脉僵硬的改变被联系。

Effect of Short-Term Whole-Body Vibration Training on Metabolic Risk Factors, Inflammatory Markers, and Arterial Stiffness

To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood parameters related to metabolic syndrome with those of aerobic training alone. Thirty healthy participants were divided into 2 groups matched for age and body mass index (BMI). Fifteen subjects were assigned to the WBV group (WBV + aerobic training) and the other 15 to the control group (aerobic training only). All participants performed a treadmill exercise 3 days/week for 4 weeks, for 50 min after 30 min rest period. Exercise was performed at a heart rate (HR) corresponding to 60% of the HR at each individual’s maximum oxygen uptake (VO2max). Body weight and BMI after training were significantly lower than those before training in the WBV group (P < 0.01). Concerning arterial stiffness, the pulse-wave velocity after training was significantly lower than that before training in the WBV group (1048.7 ± 105.6 vs. 1008.4 ± 101.1 cm/s, P < 0.05). Meanwhile, the VO2max after training was significantly higher than that before training in the WBV group (47.7 ± 12.8 vs. 51.4 ± 14.1 mL·min-1·kg-1, P < 0.01). However, no significant differences were observed in any parameters before and after training in the control group. Our results suggest that aerobic exercise combined with WBV training may be effective in reducing arterial stiffness and improving cardiorespiratory fitness than aerobic training alone.

Cardiometabolic Phenotype and Arterial Stiffness in HIV-Positive Black African Patients

Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.

The Effects of Magnesium-EDTA Chelation Therapy on Arterial Stiffness

Traditional risk factors for cardiovascular disease can only assess risks for groups of people. New parameters of arterial stiffness are more reliable for predicting cardiovascular outcomes for individuals with and without a cardiovascular history. The objective of this study was to assess the effects of Magnesium-EDTA chelation therapy using new methods and parameters such as pulse wave velocity (PWV), central blood pressure (SBPao) and endothelial function (Aix). We followed 43 patients with an abnormal PWV and SBPao, setting them up in two groups. The 21 patients in Group A had already been diagnosed with cardiovascular disease. The other 22 patients in Group B also showed abnormal PWV, SBPao and Aix, but showed no cardiovascular symptoms. Each patient in Groups A and B received one Mg-EDTA treatment per week. The total treatment plan consisted of 25 Mg-EDTA chelation treatments according to the standard protocol of IBCMT. After 25 Mg-EDTA chelation sessions, PWV and SBPao improved significantly in all patients of Groups A and B. In addition, Aix improved significantly in these patients, but remained abnormal. Group C included 18 asymptomatic patients with normal PWV or SBPao. Aix was abnormal in this group, but to a much lesser extent than Groups A and B. The 18 asymptomatic patients of Group C did not receive Mg-EDTA treatment. Observation showed no significant changes in all three parameters of arterial stiffness. The results of this study indicate that a course of treatment with Magnesium-EDTA chelation therapy significantly lowers cardiovascular risks. We conclude that Mg-EDTA chelation therapy improves PWV as an indicator of arterial stiffness, SBPao (central blood pressure) as an indicator of aortic elasticity and Aix (augmented aortic index) as an indicator of endothelial functioning. These improvements in PWV, SBPao and Aix demonstrate that atherosclerosis is a dynamic and (partially) reversible process.

A family history of diabetes is not associated with arterial stiffness in non-diabetic Japanese population

Prevalent diabetes is at high risk for cardiovascular diseases and has a high familial inheritance. However, little is known whether a non-diabetic subject with a family history of diabetes is at high risk for vascular damage or not. The purpose of this study was to evaluate the association between a family history of diabetes and arterial stiffness in adult non-diabetic Japanese population. We analyzed eligible 787 non-diabetic subjects (502 men and 285 women) aged 35-69 years who enrolled in the baseline survey of a cohort study in Tokushima Prefecture, Japan and who underwent a brachial-ankle pulse wave velocity (ba-PWV) measurement. Information on individual life-style characteristics including medical history and treatment for diseases and a first-degree family history of diabetes was obtained through a structured self-administered questionnaire. Analysis of covariance and logistic regression analyses were used to evaluate the association between a family history of diabetes and ba-PWV. We found no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted means of ba-PWVs between subjects of both sexes with and without a family history of diabetes. Logistic regression analyses including both sexes also revealed that subjects with a family history of diabetes showed no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted odds ratios for high ba-PWV compared to those without that trait. Our results suggest that a family history of diabetes itself is not associated with arterial stiffness in adult non-diabetic Japanese population.

Assessment of Arterial Stiffness Index in Hypertensive Patients in Relation to Their Treatment Status Attending a Tertiary Care Center in South India

Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls;to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months;group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status.

Immediate impact of exercise on arterial stiffness in humans

Background and objectives: Increased arterial stiffness is an accepted cardiovascular risk factor. Several studies have shown that regular exercise is associated with reduced arterial stiffness. However, the acute effect is not well known. The aim of this study was to evaluate the immediate impact of exercise on arterial stiffness measured by pulse wave velocity (PWV). Subjects and Methods: Data from 100 consecutive patients who underwent graded maximal aerobic exercise test and pulse wave velocity study due to chest pain were analyzed. Results: With respect to brachial-ankle pulse wave velocity (baPWV), it decreased after the exercise test (before vs. after;1420 ± 260 vs. 1358 ± 245, 1428 ± 255, vs. 1360 ±239 cm/sec;left and right, respectively). Upper extremity systolic blood pressure did not change from baseline. However, upper extremity diastolic blood pressure increased slightly. In addition, lower extremity blood pressure decreased in both systolic and diastolic phases. In both normotensives and hypertensives, baPWV decreased after exercise test. Conclusion: Exercise immediately decreases arterial stiffness.

Association between arterial stiffness and risk of coronary artery disease in a community-based population

Background Arterial stiffness is well known as an important risk factor for coronary artery disease.In this study,we aimed to investigate the association between carotid-ankle pulse wave velocity （caPWV） and risk of coronary artery disease （CAD）,and the interaction between pulse wave velocity （PWV） and other potential risk factors of CAD.Methods A community-based cross-sectional study was conducted for subjects living in Beijing,China.We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing.A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.Results We found CAD subjects were more likely to have a higher body massindex （BMI）,fasting glucose,uric acid,low-density lipoprotein （LDL） cholesterol,high-sensitivity Creactive protein （hs-CRP）,carotic-femoral pulse wave velocity （cfPWV） and caPWV （P ＜0.05）,and CAD subjects had a significantly lower HDL cholesterol levels （P ＜0.05）.Moreover,the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects.The multiple Logistic regression analysis showed that hypertension,higher uric acid,hs-CRP,cfPWV and caPWV levels significantly increased the risk of CAD,with ORs （Cl） of 1.47 （1.25-1.74）,1.17 （1.01-1.26）,1.35 （1.10-1.67）,1.15 （1.09-1.19） and 1.07 （1.01-1.15）,respectively.Higher HDL cholesterol was significantly associated with reduced risk of CAD,with ORs （CI） of 0.58 （0.40-0.83）.In addition,cfPWV had significant association with age,hypertension,LDL cholesterol,with Pearson＇s coefficients of 0.166,0.074,and 0.030,respectively.Conclusions cfPWV and caPWV are independently associated with significant CAD,and cfPWV has significant correlation with age and hypertension.cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.

Association of hemoglobin with arterial stiffness evaluated by carotid-femoral pulse wave velocity among Chinese adults

Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wave velocity (PWV) is a simple and noninvasive method for measuring arterial stiffness to assess cardiovascular disease in general populations. Accordingly, we conducted a cross-sectional study to explore the association of Hb with PWV. Methods: A total of 6642 adults aged 54.5 ± 11.2 years undergoing physical examinations were enrolled, 71.7% of whom were males. Arterial stiffness was evaluated by carotid-femoral PWV (cfPWV). Multivariable regression analyses were performed to determine the relationship between Hb and increased cfPWV. Results: In this study, the mean Hb (per 10 g/L increase) was 144.7 ± 13.9 g/L, and the mean cfPWV was 15.1 ± 3.1 m/s. cfPWV was significantly higher in high hemoglobin groups >15.4 g/L (Quartile 4) than in the lowest hemoglobin group (Quartile 1 < 13.6 g/L;P < 0.001). Multiple linear regression analysis revealed that Hb positively correlated with cfPWV (β= 0.16, P < 0.01). Univariate Logistic regression analysis revealed that Hb was associated with increased cfPWV, with an odd ratio (OR) of 1.46 (95% confidence interval [CI], 1.39-1.54). After adjusting for potential confounders, Hb and the highest Hb quartile group were also independently associated with increased cfPWV, with a fully adjusted OR of 1.11 (95% CI, 1.02-1.20) and 1.45 (95% CI, 1.01-2.08), respectively. Conclusion: This study demonstrated that Hb levels significantly correlate with increased cfPWV.

各年龄段人群血清神经元特异性烯醇化酶与外周动脉硬化的相关性分析

目的:研究各年龄段人群血清神经元特异性烯醇化酶(NSE)与外周动脉硬化的相关性。方法:以体检人群为研究对象,收集一般临床资料,采用免疫化学发光法测定血清NSE浓度,通过肱-踝脉搏波传导速度(baPWV)评估外周动脉硬化;根据年龄将研究人群分为3组:青年组(≤44岁)、中年组(45~59岁)和老年组(≥60岁),评估不同年龄组血清NSE水平与baPWV及外周动脉硬化的相关性。结果:共纳入7338名研究对象,青年组2847例,中年组3614例,老年组877例;各年龄组中,血清NSE浓度、收缩压、超敏C反应蛋白均为baPWV的独立影响因素(P<0.05),年龄越大,血清NSE浓度与baPWV相关性越高;各年龄组中,血清NSE浓度、心率、吸烟史、高血压、糖尿病、空腹血糖、收缩压、舒张压、甘油三酯、肌酐、白细胞均为外周动脉硬化(baPWV≥1400 cm/s)的危险因素(P<0.05);青年组及中年组中,高密度脂蛋白是外周动脉硬化的保护因素(P<0.05)。按NSE浓度四分位数进一步将各组研究人群分为4组,校正分析影响外周动脉硬化的因素。结果提示,与Q1组相比,除青年组外,中年组及老年组发生外周动脉硬化的OR值均随NSE浓度梯度递增而逐步递增(P<0.05)。结论:各年龄组人群中,baPWV数值随血清NSE浓度增加而增加,NSE是外周动脉硬化的独立危险因素,随着NSE浓度梯度递增,中年及老年人群发生外周动脉硬化的风险也逐步递增。

臂踝动脉脉搏波传导速度与发生恶性肿瘤的关系

目的探讨臂踝动脉脉搏波传导速度(baPWV)与发生恶性肿瘤的关系。方法采用横断面研究方法,研究对象为参加2010至2017年健康体检且同时参加baPWV检测的开滦集团职工(41404例)。按照baPWV水平将观察对象分为3组,分别为baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s和baPWV≥1800 cm/s。采用多因素Logistic回归模型分析不同baPWV分组与恶性肿瘤的关系。结果观察对象年龄(48.1±12.1)岁,男性占71.9%。baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s、baPWV≥1800 cm/s组发生恶性肿瘤比例分别为0.58%、0.77%、0.92%。多因素Logistic回归模型分析显示,校正混杂因素:年龄、性别、吸烟、饮酒、体育锻炼、空腹血糖、平均动脉压、腰围、体重指数、总胆固醇和C-反应蛋白,与baPWV<1400 cm/s组比较,1400≤baPWV<1800 cm/s和baPWV≥1800 cm/s组观察对象发生恶性肿瘤的OR(95%CI)值分别为1.17(1.06~1.30)、1.47(1.28~1.70)(P<0.01)。结论动脉硬化与发生恶性肿瘤有关联。

血清Adropin浓度与踝臂指数、肱-踝动脉脉搏波传导速度的相关性

目的研究血清Adropin浓度与踝臂指数(ankle brachial index,ABI)、肱-踝动脉脉搏波传导速度(brachial ankle pulse wave velocity,Ba-PWV)的相关性。方法纳入2022年1月至2023年6月心内科住院治疗的患者179例,酶联免疫吸附法检测血清Adropin浓度,测量肱、踝动脉收缩压及Ba-PWV,计算ABI。根据ABI分组:ABI较低组(ABI<0.9,n=71)和ABI较高组(ABI≥0.9,n=108)。根据Ba-PWV分组:Ba-PWV较高组(Ba-PWV≥1400 cm/s,n=118),Ba-PWV较低组(Ba-PWV<1400 cm/s,n=61)。结果与ABI较高组比较,ABI较低组高血压发病率高、血清Adropin浓度低(P<0.001)。Logistic回归分析显示:血清Adropin浓度与低ABI呈负相关(偏相关系数为-0.715,P=0.027,OR=0.529,95%CI:0.342~0.987)。ROC分析:血清Adropin浓度<2998 pg/mL可预测低ABI及动脉粥样硬化(P<0.001),ROC曲线下面积:0.864;95%CI:(0.804~0.925),灵敏度:89.8%,特异性:81.7%。与Ba-PWV较低组比较,Ba-PWV较高组空腹血糖水平高、高血压病发病率高、血清Adropin浓度低(P<0.05)。Logistic回归分析:血清adropin浓度与高Ba-PWV呈负相关(偏相关系数为-0.562,P=0.002,OR=0.587,95%CI:0.398~0.837)。ROC分析:血清Adropin浓度<3019 pg/mL可预测高Ba-PWV及动脉粥样硬化(P<0.001),ROC曲线下面积:0.861;95%CI:(0.792~0.929),灵敏度:86.9%,特异性:53.4%。结论血清Adropin浓度与大动脉硬化及外周动脉粥样硬化相关。

Intensive blood pressure control on arterial stiffness among older patients with hypertension

Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older people.This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg to<130 mmHg(intensive treatment)or 130 mmHg to<150 mmHg(standard treatment).Patients underwent repeated examinations of the brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)at baseline,and the arterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this study.Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model.The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(P<0.001).Intensive treatment significantly delayed the progression of arterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,respectively.During a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment group.Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP<140 mmHg.Conclusion:Intensive blood pressure control with an SBP target of 110 mmHg to<130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration:http://www.clinicaltrials.gov;No.NCT03015311.

原发性高血压患者血浆致动脉粥样硬化指数与动脉硬化进展的相关性研究

目的:探索原发性高血压患者血浆致动脉粥样硬化指数(plasma atherogenic index AIP)的影响因素,并研究此类患者中AIP与动脉硬化进展的相关性。方法:本研究为回顾性研究,连续选取2018年3月至2021年3月,柳州市柳铁中心医院收治的原发性高血压患者104例,男性78例,女性26例。根据患者基线AIP指数(中位数=2.8)分为高AIP组和低AIP组,比较两组基线资料及臂踝脉搏波流速(brachial ankle pulse wave velocity,ba-PWV)差异,并利用多因素Logistic回归模型分析动脉硬化(ba-PWV>1800cm/s)的影响因素。同时进行了随访,比较两组患者动脉硬化的进展差异,探索AIP与动脉硬化进展的关系。结果:两组基线资料比较发现:高AIP组[4.2(2.8,7.8)]较低AIP组[1.7(-0.3,2.8)]男性比例更大(84.6%vs.65.4%,P=0.024),BMI更大[(30.2±4.1)vs.(28.4±3.5)kg/m^(2),P=0.016],TG[2.1(1.3,3.9)vs.1.6(1.2,3.2)]mmol/L,P<0.001和ba-PWV[(1765.1±240.9)vs.(1457.2±218.4)cm/s,P<0.001]水平和ba-PWV变化率[25.0(-13.5,55.2)vs.9.3(-24.9,25.2)cm·s^(-1)·year^(-1),P<0.001]更高,动脉硬化比例更大(36.5%vs.17.3%,P=0.027)。余变量组间均差异无统计学意义(P均>0.05)。多因素Logistic回归分析显示:在调整了混杂因素后,高AIP组动脉硬化风险更大(OR=1.34,95%CI:1.07~2.03,P=0.013)。广义相加模型显示AIP与ba-PWV变化率存有剂量效应关系,在AIP指<3时,AIP每增加1个单位,ba-PWV变化率增加18.92 cm·s^(-1)·year^(-1);在AIP指数≥3时,AIP每增加1个单位,ba-PWV变化率增加1.72cm·s^(-1)·year^(-1)。结论:高AIP的原发性高血压患者年龄及ba-PWV更大,AIP增大与动脉硬化风险增加相关。高AIP患者其动脉硬化进展更快,ba-PWV变化率更大,且存在剂量效应关系:当AIP≥3时,其ba-PWV变化率的增长显著低于AIP<3时。综上,在原发性高血压患者中,AIP对于评估动脉硬化水平及其进展存在一定临床价值。