Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors
Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors
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DOI：
10.1093/eurheartj/ehu293
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发表时间：
2014-11-21
影响因子：
39.3
通讯作者：
Boutouyrie, Pierre
中科院分区：
文献类型：
--
作者：
Herbert, Annie;Cruickshank, John Kennedy;Boutouyrie, Pierre
目的估计中心收缩压(CSBP)和收缩压放大(BSBP-CSBP)是有可能预测心血管疾病的无创性指标。没有全球范围内的多设备参考值可用。我们的目标是在不同可用的测量方法之间建立标准化的全球一般人口的参考值。然后研究心血管危险因素(CVRF)是如何显著改变这些值的。方法和结果结合了现有的人口调查和临床试验数据，无论是否发表。正常(无CVRF)和参考(任何CVRF)人群的CSBP参考值和扩增以百分位数计算。我们纳入了来自53个中心的77项研究的82 930名受试者中的45 436名。纳入的受试者看起来很健康，没有接受高血压或血脂异常的治疗，也没有明显的心血管疾病和糖尿病。CSBP和放大系数的值依次按臂部血压类别和年龄10岁分层，两者均按性别分层。扩增随着年龄的增长而减少，男性比女性更明显。性别是与扩增有关的最强因素，男性的扩增率比女性高6.6毫米汞柱(5.8-7.4)。扩增受CVRFs的影响轻微但显著，吸烟和血脂异常对扩增的影响较小，但随着血糖水平的升高而增加。结论健康人群和没有传统CVRFs的人群CSBP和扩增的典型值可以根据年龄、性别和臂部血压获得，提供了不同设备的值，具有广泛的地理代表性。扩增受CVRF的影响很大，但男性和女性的影响不同。
Aims Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasivemeasures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated.Methods and results Existing data from population surveys and clinical trials were combined, whether published or not. Reference values of cSBP and amplificationwere calculated as percentiles for 'Normal' (no CVRFs) and 'Reference' (any CVRFs) populations. We included 45 436 subjects out of 82 930 that were gathered from 77 studies of 53 centres. Included subjects were apparently healthy, not treated for hypertension or dyslipidaemia, and free from overt CV disease and diabetes. Values of cSBP and amplification were stratified by brachial blood pressure categories and age decade in turn, both being stratified by sex. Amplification decreased with age and more so in males than in females. Sex was the mostpowerful factor associated with amplification with 6.6 mmHg(5.8-7.4) higher amplification in males than in females. Amplification was marginally but significantly influenced by CVRFs, with smoking and dyslipidaemia decreasing amplification, but increased with increasing levels of blood glucose.Conclusion Typical values of cSBP and amplification in a healthy population and a population free of traditional CVRFs are now available according to age, sex, and brachial BP, providing values included from different devices with a wide geographical representation. Amplification is significantly influenced by CVRFs, but differently in men and women.