Changes in arterial stiffness and wave reflection with advancing age in healthy men and women - The Framingham Heart Study
Changes in arterial stiffness and wave reflection with advancing age in healthy men and women - The Framingham Heart Study
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DOI：
10.1161/01.hyp.0000128420.01881.aa
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发表时间：
2004-06-01
期刊：
影响因子：
8.3
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Mitchell, GF;Parise, H;Levy, D
随着年龄的增长，动脉僵硬度和波反射增加并升高收缩压和脉压。中心脉压升高通常归因于波反射增加，预示预后不良。使用动脉张力计，我们评估了中心（颈动脉-股动脉）和外周（颈动脉-肱动脉）脉搏波速度，前向和反射压力波的振幅，以及增强指数，这些患者来自心脏病研究的188名男性和333名女性后代队列，他们在过去12个月内没有临床心血管疾病、高血压、糖尿病、吸烟、血脂异常和肥胖。在多变量线性回归模型中，年龄增长是颈动脉-股动脉脉搏波速度较高的主要相关因素;其他相关因素包括平均动脉压、心率、甘油三酯和眼压测量前的步行试验（模型R-2 = 0.512，P < 0.001）。颈动脉-肱动脉脉搏波传导速度的模型相似（模型R-2 = 0.227，P < 0.001），但随年龄增长的增加较小。由于年龄与中央和外周僵硬度测量的不同关系，颈动脉-股动脉脉搏波速度在50岁之前低于颈动脉-肱动脉脉搏波速度，但在50岁之后超过了颈动脉-股动脉脉搏波速度，导致正常的中央-外周动脉僵硬度梯度逆转。在这个心血管疾病风险因素负担最小的健康队列中，与外周动脉僵硬度相比，年龄相关的主动脉僵硬度增加与前向波振幅和脉压增加以及动脉僵硬度梯度逆转相关。这种现象可促进潜在有害的压力脉动向前传输到外围。
With advancing age, arterial stiffness and wave reflections increase and elevate systolic and pulse pressures. An elevated central pulse pressure is generally ascribed to increased wave reflection and portends an unfavorable prognosis. Using arterial tonometry, we evaluated central (carotid-femoral) and peripheral (carotid-brachial) pulse wave velocity, amplitudes of forward and reflected pressure waves, and augmentation index in 188 men and 333 women in the Framingham Heart Study offspring cohort who were free of clinical cardiovascular disease, hypertension, diabetes, smoking within the past 12 months, dyslipidemia, and obesity. In multivariable linear regression models, advancing age was the predominant correlate of higher carotid-femoral pulse wave velocity; other correlates were higher mean arterial pressure, heart rate, and triglycerides and walk test before tonometry (model R-2 = 0.512, P < 0.001). A similar model was obtained for carotid-brachial pulse wave velocity (model R-2 = 0.227, P < 0.001), although the increase with advancing age was smaller. Owing to different relations of age to central and peripheral stiffness measures, carotid-femoral pulse wave velocity was lower than carotid-brachial pulse wave velocity before age 50 years but exceeded it thereafter, leading to reversal of the normal central-to-peripheral arterial stiffness gradient. In this healthy cohort with a minimal burden of cardiovascular disease risk factors, an age-related increase in aortic stiffness, as compared with peripheral arterial stiffness, was associated with increasing forward wave amplitude and pulse pressure and reversal of the arterial stiffness gradient. This phenomenon may facilitate forward transmission of potentially deleterious pressure pulsations into the periphery.