Relationship Between Short-Term Blood Pressure Variability and Large-Artery Stiffness in Human Hypertension Findings From 2 Large Databases
Relationship Between Short-Term Blood Pressure Variability and Large-Artery Stiffness in Human Hypertension Findings From 2 Large Databases
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DOI：
10.1161/hypertensionaha.112.197491
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发表时间：
2012-08-01
期刊：
影响因子：
8.3
通讯作者：
Parati, Gianfranco
中科院分区：
文献类型：
--
作者：
Schillaci, Giuseppe;Bilo, Grzegorz;Parati, Gianfranco
短期血压（BP）变异性可预测高血压患者的心血管并发症，但其与大动脉僵硬度的关系尚不清楚，并受到与24小时内BP变化评估相关的方法学问题的混淆。在911例未经治疗的非糖尿病高血压患者（学习人群）和2089例主要接受治疗的高血压患者（83%接受治疗，25%糖尿病患者;测试人群）中测量颈动脉-股动脉脉搏波速度（cfPWV）和24小时动态血压。短期收缩压（SBP）变异性计算如下：（1）24小时、日间或夜间SBP的SD;（2）24小时SBP的加权SD;（3）平均真实的变异性（ARV），即24小时内连续SBP测量值之间绝对差异的平均值。在学习人群中，所有SBP变异性指标均与cfPWV直接相关（24小时、白天和夜间SBP的SD，r=0.17/0.19/0.13; 24小时SBP的加权SD，r=0.21; ARV，r=0.26;所有P < 0.001）。cfPWV与ARV的相关性强于24小时、白天和夜间SBP（均P < 0.05），与24小时SBP的加权SD相似。在受试人群中，ARV和24小时SBP的加权SD与cfPWV的相关性强于24小时、白天或夜间SBP的SD。在两个人群中，SBP变异性指数独立预测cfPWV沿着年龄、24小时SBP和其他因素。我们的结论是，短期变化的24小时收缩压显示了一个独立的，但适度的，与主动脉僵硬度在高血压。这种关系更强的措施，血压变异性侧重于短期的变化，如ARV和加权24小时SD。（高血压。2012; 60：369-377）。circle在线数据补充
Short-term blood pressure (BP) variability predicts cardiovascular complications in hypertension, but its association with large-artery stiffness is poorly understood and confounded by methodologic issues related to the assessment of BP variations over 24 hours. Carotid-femoral pulse wave velocity (cfPWV) and 24-hour ambulatory BP were measured in 911 untreated, nondiabetic patients with uncomplicated hypertension (learning population) and in 2089 mostly treated hypertensive patients (83% treated, 25% diabetics; test population). Short-term systolic BP (SBP) variability was calculated as the following: (1) SD of 24-hour, daytime, or nighttime SBP; (2) weighted SD of 24-hour SBP; and (3) average real variability (ARV), that is, the average of the absolute differences between consecutive SBP measurements over 24 hours. In the learning population, all of the measures of SBP variability showed a direct correlation with cfPWV (SD of 24-hour, daytime, and nighttime SBP, r=0.17/0.19/0.13; weighted SD of 24-hour SBP, r=0.21; ARV, r=0.26; all P < 0.001). The relationship between cfPWV and ARV was stronger than that with 24-hour, daytime, or nighttime SBP (all P < 0.05) and similar to that with weighted SD of 24-hour SBP. In the test population, ARV and weighted SD of 24-hour SBP had stronger relationships with cfPWV than SD of 24-hour, daytime, or nighttime SBP. In both populations, SBP variability indices independently predicted cfPWV along with age, 24-hour SBP, and other factors. We conclude that short-term variability of 24-hour SBP shows an independent, although moderate, relation to aortic stiffness in hypertension. This relationship is stronger with measures of BP variability focusing on short-term changes, such as ARV and weighted 24-hour SD. (Hypertension. 2012; 60: 369-377.) circle Online Data Supplement