Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study.
Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study.
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DOI：
10.1161/hypertensionaha.117.09026
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发表时间：
2017-08
期刊：
影响因子：
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通讯作者：
Vasan RS
中科院分区：
文献类型：
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作者：
Niiranen TJ;Lyass A;Larson MG;Hamburg NM;Benjamin EJ;Mitchell GF;Vasan RS
高血压和血管僵硬度增加被视为衰老不可避免的部分。为了阐明与年龄相关的血管功能下降是否可以避免，我们评估了 3196 名年龄≥50 岁的弗雷明汉研究参与者的健康血管老化 (HVA) 的患病率、相关性和预后。我们将 HVA 定义为不存在高血压且脉搏波速度 <7.6 m/s（年龄<30 岁的参考样本的平均值+2SD）。总体而言，566 人 (17.7%) 患有 HVA，患病率从 50-59 岁人群的 30.3% 降至 70 岁以上人群的 1.0%。在针对体力活动、热量摄入和传统心血管疾病 (CVD) 危险因素进行调整的回归模型中，我们观察到较低年龄、女性、较低体重指数、使用降脂药物和没有糖尿病与 HVA 存在横断面相关性（全部 P<0.001）。心血管健康评分 (Life’s Simple 7) 每增加一个单位，经年龄和性别调整的 HVA 几率就会增加 1.55 倍（95% 置信区间 [CI]，1.38–1.74）。在 9.6 年的随访中，发生了 391 起 CVD 事件。在针对传统 CVD 危险因素（包括血压）进行调整的 Cox 回归模型中，相对于不存在 HVA，HVA 与 CVD 的风险比为 0.45（95% CI，0.26-0.77）。尽管 HVA 对于已经适应西方生活方式的人来说是可以实现的，但在 70 岁以后维持正常的血管功能是具有挑战性的。尽管我们的数据是观察性的，但我们的研究结果支持针对可改变的因素和行为，特别是肥胖的预防策略，以预防或延缓血管衰老以及相关的心血管疾病风险。
Hypertension and increased vascular stiffness are viewed as inevitable parts of aging. To elucidate whether the age-related decrease in vascular function is avoidable, we assessed the prevalence, correlates, and prognosis of healthy vascular aging (HVA) in 3196 Framingham Study participants aged ≥50 years. We defined HVA as absence of hypertension and pulse wave velocity <7.6 m/s (mean+2SD of a reference sample aged <30 years). Overall, 566 (17.7%) individuals had HVA, with prevalence decreasing from 30.3% in persons aged 50–59 to 1.0% in those aged ≥70 years. In regression models adjusted for physical activity, caloric intake, and traditional cardiovascular disease (CVD) risk factors, we observed that lower age, female sex, lower body mass index, use of lipid-lowering drugs, and absence of diabetes were cross-sectionally associated with HVA (P<0.001 for all). A unit increase in a cardiovascular health score (Life’s Simple 7) was associated with 1.55-fold (95% confidence interval [CI], 1.38–1.74) age- and sex-adjusted odds of HVA. Over a follow-up of 9.6 years, 391 CVD events occurred. In Cox regression models adjusted for traditional CVD risk factors, including blood pressure, HVA was associated with a hazard ratio of 0.45 (95% CI, 0.26–0.77) for CVD relative to absence of HVA. Although HVA is achievable in individuals acculturated to a Western lifestyle, maintaining normal vascular function beyond age 70 years is challenging. Although our data are observational, our findings support prevention strategies targeting modifiable factors and behaviors, and obesity, in particular, to prevent or delay vascular aging and the associated risk of CVD.