Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth
Blood Pressure and Obesity Exert Independent Influences on Pulse Wave Velocity in Youth
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DOI：
10.1161/hypertensionaha.112.194746
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发表时间：
2012-08-01
期刊：
影响因子：
8.3
通讯作者：
Redon, Josep
中科院分区：
文献类型：
--
作者：
Lurbe, Empar;Torro, Isabel;Redon, Josep
目的是分析脉搏波传导速度（PWV）在正常血压，高正常，高血压的青年人使用从周边记录的心电图衍生的参数。还分析了肥胖对血管表型的影响。共有501名8至18岁的白人被纳入其中。受试者根据血压标准进行分组：424例（85%）血压正常，56例（11%）高正常，21例（4%）高血压。肥胖284人（56%），超重138人（28%）。使用SphygmoCor器械进行脉搏波分析，以确定中心血压（BP）、增强指数和PWV测量值。在BP组中，年龄、性别和身高存在差异，但体重指数无差异。组内观察到外周和中心收缩压和舒张压以及脉压的显著差异。在BP分层中，PWV分级增加，增强指数无差异。使用多元回归分析，年龄，血压组和肥胖状态与PWV独立相关。老年人和高血压受试者的PWV最高，而从正常体重状态到肥胖，PWV下降。同样，PWV与外周或中心收缩压呈正相关，与体重指数z评分呈负相关。对于外周收缩压的1个SD，PWV增加0.329 m/s，对于体重指数z评分的1个SD，PWV降低0.129 m/s。总之，PWV在高血压患者中增加，甚至在高正常儿童和青少年中也是如此。此外，肥胖是青少年原发性高血压最常见的相关因素，它使高血压和高正常受试者的PWV预期增量变钝。（高血压。2012; 60：550-555）。
The objective was to analyze pulse wave velocity (PWV) in normotensive, high-normal, and hypertensive youths by using aortic-derived parameters from peripheral recordings. The impact of obesity on vascular phenotypes was also analyzed. A total of 501 whites from 8 to 18 years of age were included. The subjects were divided according to BP criteria: 424 (85%) were normotensive, 56 (11%) high-normal, and 21 (4%) hypertensive. Obesity was present in 284 (56%) and overweight in 138 (28%). Pulse wave analysis using a SphygmoCor device was performed to determine central blood pressure (BP), augmentation index, and measurement of PWV. Among the BP groups, differences appeared in age, sex, and height but not in body mass index. Significant differences in peripheral and central systolic and diastolic BPs and pulse pressures were observed within groups. A graded increase in PWV was present across the BP strata without differences in augmentation index. Using a multiple regression analysis, age, BP groups, and obesity status were independently associated with PWV. Older and hypertensive subjects had the highest PWV, whereas, from normal weight status to obesity, PWV decreased. Likewise, PWV was positively related to peripheral or central systolic BP and negatively related to body mass index z score. For 1 SD of peripheral systolic BP, PWV increased 0.329 m/s, and for 1 SD of body mass index z score PWV decreased 0.129 m/s. In conclusion, PWV is increased in hypertensive and even in high-normal children and adolescents. Furthermore, obesity, the factor most frequently related to essential hypertension in adolescents, blunted the expected increment in PWV of hypertensive and high-normal subjects. (Hypertension. 2012; 60: 550-555.)