Age-independent association of pulse pressure with cerebral white matter lesions in asymptomatic elderly individuals
Age-independent association of pulse pressure with cerebral white matter lesions in asymptomatic elderly individuals
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DOI：
10.1097/hjh.0b013e3283408ffb
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发表时间：
2011-02-01
影响因子：
4.9
通讯作者：
Yoon, Byung-Woo
中科院分区：
文献类型：
--
作者：
Kim, Chi Kyung;Lee, Seung-Hoon;Yoon, Byung-Woo
目的肱脉压（Brachial pulse pressure， PP）是老年人动脉僵硬度的标志，也是衡量血管老化的有效工具。脑白质病变（WMLs）的存在是亚临床缺血性脑损伤的影像学标志。脑损伤可能是年龄相关的退行性改变，但很少有研究表明血管老化与脑损伤之间的关系。在这项研究中，我们评估了臂丛PP是否与老年人脑白质损伤的存在有关。方法对692例进行常规健康检查的无症状老年人（年龄0 ~ 55岁）进行分析。测量肱血压（BP），并用脑MRI确定晚期脑脑损伤的存在。结果晚期脑损伤96例（13.9%）。在PP最高的四分位数（>= 54 mmHg）中，55例（32.9%）患有晚期脑白质损伤，这明显高于其他四分位数。在控制了年龄、高血压、收缩压、舒张压、阿司匹林使用、c反应蛋白和其他血管危险因素后，PP最高四分位数与晚期脑梗死显著相关，而最低四分位数与晚期脑梗死显著相关[校正优势比（OR） 2.55；95%置信区间（CI） 1.03-6.30]。结论：作者首次报道，在无症状的老年人中，臂丛PP升高与脑白质损伤无关。这一结果提示，PP作为一种假定的血管老化标志物，可以预测亚临床脑血管疾病的存在。[J] .中国医学杂志，2011,29 (3):325-329 (C)。
Objective Brachial pulse pressure (PP) is a marker of arterial stiffness in the elderly and a useful tool for measuring vascular aging. The presence of cerebral white matter lesions (WMLs) is a radiological marker of sub-clinical ischemic brain damage. WMLs may be age-related degenerative change, but few studies have addressed the relationship between vascular aging and WMLs. In this study, we assessed whether brachial PP is associated with the presence of WMLs in the elderly.Methods Six hundred and ninety-two asymptomatic elderly individuals (>55 years) who visited for routine health checkup were included. Brachial blood pressure (BP) was measured and brain MRI used to determine the presence of advanced WMLs.Results Ninety-six (13.9%) were found to have advanced WMLs. In the highest PP quartile (>= 54 mmHg), 55 (32.9%) had advanced WMLs, and this was significantly higher than in other quartiles. After controlling for age, hypertension, systolic BP, diastolic BP, aspirin use, C-reactive protein, and other vascular risk factors, the highest quartile of PP was significantly associated with advanced WMLs compared with the lowest quartile [adjusted odds ratio (OR) 2.55; 95% confidence interval (CI) 1.03-6.30].Conclusions The authors report for the first time that increased brachial PP is an age-independently associated with WMLs in asymptomatic elderly individuals. This result suggests that PP as a presumed marker of vascular aging may predict the presence of sub-clinical cerebrovascular diseases. J Hypertens 29:325-329 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.