Atherosclerosis of the carotid bulb is associated with the severity of orthostatic hypotension in non-diabetic adult patients: a cross-sectional study
Atherosclerosis of the carotid bulb is associated with the severity of orthostatic hypotension in non-diabetic adult patients: a cross-sectional study
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DOI：
10.1080/10641963.2018.1465073
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发表时间：
2019-02-17
影响因子：
12.3
通讯作者：
Tamura, Kouichi
中科院分区：
文献类型：
--
作者：
Kobayashi, Yusuke;Ishiguro, Hiroaki;Tamura, Kouichi
背景：颈动脉球具有高密度的压力感受器，其在维持血压中起重要作用。我们假设颈动脉球的动脉粥样硬化比其他颈动脉段的动脉粥样硬化更能准确地反映体位性低血压的严重程度。方法：这项横断面研究包括198名非糖尿病成人。我们测量了心血管踝指数作为动脉硬度的指标，每个颈动脉段（颈内动脉，颈动脉球，颈总动脉的远端和近端部分）的内膜-中层厚度作为动脉粥样硬化的指标，心率变异性作为心脏自主神经功能的指标。采用坐立试验评估直立性低血压的严重程度。结果如下：颈动脉球内膜中层厚度与立位收缩压变化（r =-0.218，p = 0.002）、心踝血管指数（r = 0.365，p < 0.001）和心率变异性参数相关。多变量回归分析显示，在所有的节段中，只有颈动脉球的内膜中层厚度是直立性收缩压变化的独立预测因子（p = 0.022）。结论：颈动脉球的粥样硬化与体位性低血压、动脉硬化和心脏自主神经功能障碍的严重程度相关。
Background: The carotid bulb has a high density of baroreceptors that play an important role in maintaining blood pressure. We hypothesized that atherosclerosis of the carotid bulb would reflect the severity of orthostatic hypotension more accurately than would atherosclerosis of other carotid artery segments. Methods: This cross-sectional study included 198 non-diabetic adults. We measured the cardio-vascular ankle index as an index of arterial stiffness, intima-media thickness in each carotid artery segment (internal carotid artery, carotid bulb, distal and proximal portions, respectively, of the common carotid artery) as a measure of atherosclerosis, and heart rate variability as a measure of cardiac autonomic function. The sit-to-stand test was used to assess severity of orthostatic hypotension. Results: Intima-media thickness of the carotid bulb was correlated with orthostatic systolic blood pressure change (r = -0.218, p = 0.002), cardio-ankle vascular index (r = 0.365, p < 0.001) and heart rate variability parameters. Multivariate regression analysis revealed that among all of the segments, only intima-media thickness of the carotid bulb was an independent predictor of orthostatic systolic blood pressure change (p = 0.022). Conclusion: Atherosclerosis of the carotid bulb was associated with severity of orthostatic hypotension, arterial stiffening and cardiac autonomic dysfunction than that of other carotid artery segments.