Aortic stiffness and blood pressure variability in young people: a multimodality investigation of central and peripheral vasculature.
Aortic stiffness and blood pressure variability in young people: a multimodality investigation of central and peripheral vasculature.
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年轻人的主动脉僵硬和血压变异性：中央和周围脉管系统的多模式研究。
DOI：
10.1097/hjh.0000000000001192
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发表时间：
2017-03
影响因子：
4.9
通讯作者：
Leeson P
中科院分区：
文献类型：
--
作者：
Boardman H;Lewandowski AJ;Lazdam M;Kenworthy Y;Whitworth P;Zwager CL;Francis JM;Aye CY;Williamson W;Neubauer S;Leeson P
血压（BP）变异性增加是年轻人的心血管风险标志，可能与他们的主动脉缓冲心输出量的能力有关。我们采用多模态方法来确定中央和外周动脉僵硬度与血压变异性之间的关系。我们研究了152名成年人（平均年龄31岁），他们的血压变异性测量基于清醒动态血压的SD、24小时加权SD和平均真实的变异性（ARV）。通过心血管磁共振测量整体和局部主动脉扩张性，通过心踝血管指数（CAVI）测量动脉硬度，通过SphygmoCor（颈-股动脉）和Vicorder（肱-股动脉）测量脉搏波速度（PWV）。在无明显心血管疾病的年轻人中，所有SBP和DBP变异性指标均与主动脉扩张性相关（总体主动脉扩张性与清醒SBP SD：r =-0.39，P <0.001; SBP ARV：r =-0.34，P <0.001;加权24小时SBP SD：r =-0.42，P <0.001）。 CAVI与主动脉扩张性密切相关，也与DBP变异性、清醒SBP SD（r = 0.19，P <0.05）和24 h SBP加权SD（r = 0.24，P <0.01）相关，且有SBP ARV的趋势（r = 0.17，P = 0.06）。 而PWV仅与SBP的加权SD（r = 0.20，P= 0.03）及DBP的加权ARV（r = 0.20，P =0.03）相关。 年轻人的血压变异性较大与中心主动脉僵硬度增加有关，从年轻时开始测量和保护主动脉功能的策略可能对降低心血管风险很重要。
Increased blood pressure (BP) variability is a cardiovascular risk marker for young individuals and may relate to the ability of their aorta to buffer cardiac output. We used a multimodality approach to determine relations between central and peripheral arterial stiffness and BP variability. We studied 152 adults (mean age of 31 years) who had BP variability measures based on SD of awake ambulatory BPs, 24-h weighted SD and average real variability (ARV). Global and regional aortic distensibility was measured by cardiovascular magnetic resonance, arterial stiffness by cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) by SphygmoCor (carotid–femoral) and Vicorder (brachial–femoral). In young people, free from overt cardiovascular disease, all indices of SBP and DBP variability correlated with aortic distensibility (global aortic distensibility versus awake SBP SD: r = −0.39, P < 0.001; SBP ARV: r = −0.34, P < 0.001; weighted 24-h SBP SD: r = −0.42, P < 0.001). CAVI, which closely associated with aortic distensibility, also related to DBP variability, as well as awake SBP SD (r = 0.19, P < 0.05) and weighted 24-h SBP SD (r = 0.24, P < 0.01), with a trend for SBP ARV (r = 0.17, P = 0.06). In contrast, associations with PWV were only between carotid–femoral PWV and weighted SD of SBP (r = 0.20, P = 0.03) as well as weighted and ARV of DBP. Greater BP variability in young people relates to increases in central aortic stiffness, strategies to measure and protect aortic function from a young age may be important to reduce cardiovascular risk.