Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period
Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period
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DOI：
10.1161/hc1002.105135
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发表时间：
2002-03-12
期刊：
影响因子：
37.8
通讯作者：
Guize, L
中科院分区：
文献类型：
--
作者：
Benetos, A;Adamopoulos, C;Guize, L
背景：动脉老化导致的弹性动脉僵硬是心血管风险的独立指标。本纵向研究的目的是比较治疗高血压患者和正常高血压患者6年期间主动脉僵硬的进展，并评估这种进展的决定因素。方法和结果：本分析的数据来自483名受试者，他们在调查预防和诊所中心进行了两次健康检查，第一次是在1992-1993年，第二次是在1998-1999年。应用颈股脉波速度（PWV）评估187例首次就诊时和随访期间接受治疗的高血压患者，以及296例首次就诊时血压正常且随访期间未接受治疗的高血压患者的主动脉僵硬度。在这两个人群中，老年受试者的PWV进展更快。接受治疗的高血压患者的PWV年进展率明显高于血压正常者。只有在两次就诊时血压水平控制良好且接受治疗的高血压患者的PWV进展与血压正常者相似。在接受治疗的高血压患者中，第一次就诊时的高心率和高肌酐与PWV的加速进展有关。结论：高血压、高心率和高血清肌酐是高血压患者主动脉僵硬加速进展的主要决定因素。这是第一个在长时间内评估动脉老化决定因素的纵向研究。
Background-Elastic artery stiffness, a result of arterial aging, is an independent indicator Of Cardiovascular risk. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 6-year period in treated hypertensive subjects and normotensive subjects, and to evaluate the determinants of this progression.Methods and Results-Data for the present analysis were gathered from 483 subjects who had 2 health checkups at the Centre d'Investigations Preventives et Cliniques, the First one in 1992-1993 and the second one in 1998-1999. Carotid-femoral pulse wave velocity (PWV) was used to evaluate aortic stiffness in 187 hypertensive subjects who were under treatment at the time of the first visit and throughout the follow-up period, and in 296 subjects who were classified as normotensive during the first visit and who remained treatment-free throughout the follow-up period. In both populations, PWV progression was higher in older subjects. Annual rates of progression in PWV in treated hypertensives were significantly higher than in normotensives. Only treated hypertensives with well-controlled blood pressure levels at the time of both visits had a PWV progression similar to that of normotensives. In treated hypertensives, high heart rate and high creatinine during the first visit were associated with an accelerated progression in PWV.Conclusions-The presence of high blood pressure, high heart rate, and high serum creatinine were the major determinants of accelerated progression of aortic stiffness in treated hypertensives. This is the first longitudinal study to evaluate the determinants of arterial aging over an extended period of time.