Relations of Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness in Blacks: The Jackson Heart Study.
Relations of Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness in Blacks: The Jackson Heart Study.
复制标题
微血管功能，心血管疾病危险因素和黑人主动脉僵硬的关系：杰克逊心脏研究。
DOI：
10.1161/jaha.118.009515
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发表时间：
2018-10-16
影响因子：
5.4
通讯作者：
Fox ER
中科院分区：
文献类型：
--
作者：
Cooper LL;Musani SK;Washington F;Moore J;Tripathi A;Tsao CW;Hamburg NM;Benjamin EJ;Vasan RS;Mitchell GF;Fox ER
与白人相比，黑人具有更严重的内皮功能障碍和主动脉僵硬。
我们评估了1458个黑人参与者（n = 965 [66％的女性]，平均年龄：66±11岁）的前臂血管反应性高血症（微血管功能的指标）和主动脉僵硬。基线和反应性充血期间的血液流动5分钟后，前臂缺血。在多变量中根据心血管疾病风险因素和平均动脉压的模型，颈动脉脉搏波速度较高（β= -0.106±0.033; p = 0.001与基线较低有关-0.128±0.030；
在黑色样本中，反应性充血期间，较高的主动脉僵硬和压力搏动性与较低的流量储备有关，仅仅归因于传统心血管疾病危险因素的变化。
Blacks have more severe endothelial dysfunction and aortic stiffening as compared with whites. We aimed to investigate the association between aortic stiffness and microvascular function in the black community. We assessed the association between forearm vascular reactive hyperemia (an indicator of microvascular function) and aortic stiffness in 1458 black participants (N=965 [66% women]; mean age: 66±11 years) in the Jackson Heart Study. We evaluated 2 measures of aortic stiffness: brachial pulse pressure and carotid‐femoral pulse wave velocity. Using high‐resolution ultrasound and Doppler, we evaluated brachial blood flow at baseline and during reactive hyperemia after 5 minutes of forearm ischemia. Multiple cardiovascular risk factors were significantly related to baseline and hyperemic brachial flow velocity. Women had lower baseline flow across the entire age spectrum. During hyperemia, we observed a significant age‐sex interaction for flow velocity (P=0.02). Female sex was protective against microvascular dysfunction among younger participants, but older women exhibited a greater attenuation of the hyperemic flow reserve. In multivariable models that adjusted for cardiovascular disease risk factors and mean arterial pressure, higher carotid‐femoral pulse wave velocity (β=−0.106±0.033; P=0.001 was related to lower baseline flow. However, during reactive hyperemia, elevated brachial pulse pressure (β=−0.070±0.031; P=0.03) and carotid‐femoral pulse wave velocity (β=−0.128±0.030; P<0.001) were both related to attenuated brachial flow velocity. In a sample of blacks, higher aortic stiffness and pressure pulsatility were associated with lower flow reserve during reactive hyperemia, beyond changes attributable to traditional cardiovascular disease risk factors alone.