Determinants of the Ambulatory Arterial Stiffness Index in 7604 Subjects From 6 Populations
Determinants of the Ambulatory Arterial Stiffness Index in 7604 Subjects From 6 Populations
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DOI：
10.1161/hypertensionaha.108.119511
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发表时间：
2008-12-01
期刊：
影响因子：
8.3
通讯作者：
Staessen, Jan A.
中科院分区：
文献类型：
--
作者：
Adiyaman, Ahmet;Dechering, Dirk G.;Staessen, Jan A.
动态动脉僵硬指数（AASI）来源于24小时动态血压记录。我们研究了个体受试者AASI回归线的拟合优度（r(2)）是否会影响AASI与舒张压和收缩压之间关系的既定决定因素之间的关联。我们构建了动态血压与心血管结局相关的国际数据库（来自6个国家的7604名参与者）。AASI等于个体24小时动态记录中舒张压对收缩压的回归斜率。AASI与年龄、24小时平均动脉压呈正相关，与身高、24小时心率呈负相关。AASI与年龄、身高、24小时平均血压、24小时心率的单相关系数和相互调整的偏回归系数由r的最低四分位数向最高四分位数递增(2)。这些发现在喝咖啡者和不喝咖啡者（昼夜收缩压比= 0.90）、女性和男性以及欧洲人、亚洲人和南美人身上都是一致的。AASI与舒张压和收缩压之间关系的这些决定因素相关的累积z评分随r(2)呈曲线上升，其中大部分相关性改善发生在r(2)的第20个百分位以上（0.36）。总之，AASI回归线的较好拟合提高了将AASI作为动脉硬度指标的分析的统计能力。r(2)值为0.36可能是敏感性分析中改善心血管风险分层的阈值。[中国高血压杂志];2008;52:1038-1044.]
The ambulatory arterial stiffness index (AASI) is derived from 24-hour ambulatory blood pressure recordings. We investigated whether the goodness-of-fit of the AASI regression line in individual subjects (r(2)) impacts on the association of AASI with established determinants of the relation between diastolic and systolic blood pressures. We constructed the International Database on the Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes (7604 participants from 6 countries). AASI was unity minus the regression slope of diastolic on systolic blood pressure in individual 24-hour ambulatory recordings. AASI correlated positively with age and 24-hour mean arterial pressure and negatively with body height and 24-hour heart rate. The single correlation coefficients and the mutually adjusted partial regression coefficients of AASI with age, height, 24-hour mean pressure, and 24-hour heart rate increased from the lowest to the highest quartile of r(2). These findings were consistent in dippers and nondippers (night: day ratio of systolic pressure >= 0.90), women and men, and in Europeans, Asians, and South Americans. The cumulative z score for the association of AASI with these determinants of the relation between diastolic and systolic blood pressures increased curvilinearly with r(2), with most of the improvement in the association occurring above the 20th percentile of r(2) (0.36). In conclusion, a better fit of the AASI regression line enhances the statistical power of analyses involving AASI as marker of arterial stiffness. An r(2) value of 0.36 might be a threshold in sensitivity analyses to improve the stratification of cardiovascular risk. (Hypertension. 2008; 52: 1038-1044.)