Ethnic differences in arterial wave reflections and normative equations for augmentation index.
Ethnic differences in arterial wave reflections and normative equations for augmentation index.
复制标题
动脉波反射的种族差异和增强指数的规范方程。
DOI：
10.1161/hypertensionaha.110.166348
复制
发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
McEniery CM
中科院分区：
文献类型：
--
作者：
Chirinos JA;Kips JG;Roman MJ;Medina-Lezama J;Li Y;Woodiwiss AJ;Norton GR;Yasmin;Van Bortel L;Wang JG;Cockcroft JR;Devereux RB;Wilkinson IB;Segers P;McEniery CM
关于波反射的种族差异的数据非常有限，这对中心压力分布有显著影响。此外，由于年龄、心率和身高是增加指数的强烈决定因素，将单项测量与标准数据(其中增加指数值对应于其决定因素的平均总体值)联系起来是具有挑战性的。我们研究了参加大规模人口研究的10,550名成年人的受试者水平数据。在一个健康的参考样本(n=3,497)中，我们评估了增大指数(第二/第一收缩峰值的比率)的种族差异，并生成了调整后的z分数的方程，允许在相同年龄、性别、种族、身高和心率的受试者的个体增大指数测量值与标准总体平均值之间进行标准化比较。在调整了年龄、身高、心率和平均动脉压后，非洲黑人(女性：154%；男性：138%)和安第斯拉美裔(女性：152%；男性：133%)显示出比英国白人(女性：140%；男性：128%)更高的中心(主动脉)增强指数；而美国印第安人(女性：133%；男性：122%)表现出较低的增强指数(均为P<；0.0001)，而中国白人和英国白人之间没有显著差异。径向增大指数也有类似的结果。成功地生成了z分数的非线性种族/性别特定方程，以调整年龄、身高和心率的个体增大指数值。增大指数存在明显的民族差异，这可能是导致高血压器官损害的民族差异的原因之一。我们的研究提供了标准化的数据，在排除各种生理决定因素的影响后，可以用来补充不同种族人群中男性和女性个体血流动力学评估的解释。
Data regarding ethnic differences in wave reflections, which markedly affect the central pressure profile, are very limited. Furthermore, because age, heart rate and body height are strong determinants of augmentation index, relating single measurements to normative data (in which augmentation index values correspond to average population values of its determinants) is challenging. We studied subject-level data from 10,550 adults enrolled in large population-based studies. In a healthy reference sample (n=3,497), we assessed ethnic differences in augmentation index (ratio of second/first systolic peaks) and generated equations for adjusted z-scores, allowing for a standardized comparison between individual augmentation index measurements and the normative population mean from subjects of the same age, gender, ethnic population, body height and heart rate. After adjustment for age, body height, heart rate and mean arterial pressure, African blacks (women:154%; men:138%) and Andean-Hispanics (women:152%; men:133%) demonstrated higher central (aortic) augmentation index values than British whites (women:140%; men:128%); whereas American Indians (women:133%; men:122%) demonstrated lower augmentation index (all P<0.0001), without significant differences between Chinese and British whites. Similar results were found for radial augmentation index. Non-linear ethnic/gender-specific equations for z-scores were successfully generated to adjust individual augmentation index values for age, body height and heart rate. Marked ethnic differences in augmentation index exist, which may contribute to ethnic differences in hypertensive organ damage. Our study provides normative data that can be used to complement the interpretation of individual hemodynamic assessments among men and women of various ethnic populations, after removing the effect of various physiologic determinants.