Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore longitudinal study of aging
Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore longitudinal study of aging
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DOI：
10.1016/j.jacc.2007.10.065
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发表时间：
2008-04-08
影响因子：
24
通讯作者：
Lakatta, Edward G.
中科院分区：
文献类型：
--
作者：
Najjar, Samer S.;Scuteri, Angelo;Lakatta, Edward G.
目的本研究旨在评价脉搏波速度（PWV）作为一种无创性动脉僵硬度指标是否可预测收缩压（SBP）的纵向变化和高血压的发生。背景虽然动脉僵硬度被认为是SBP年龄相关变化的部分原因，特别是在老年，方法对449名血压正常或未经治疗的高血压志愿者进行脉搏波传导速度的基线测量（年龄53 +/- 17岁）。在平均随访4.9 +/-2.5 years.Results中，对协变量（包括年龄、体重指数和平均动脉压）进行调整后，线性混合效应回归模型显示PWV是SBP纵向增加的独立决定因素（与时间的相互作用项p = 0.003）。在基线血压正常的306例受试者中，105例（34%）在中位4.3年（范围2 - 12年）的随访期间发生高血压。逐步的考克斯比例风险模型，PWV是一个独立的预测事件高血压（风险比1.10每1米/秒的PWV增加，95%置信区间1.00至1.30，p = 0.03）在个人的随访时间大于medium.Conclusions脉搏波速度是一个独立的预测纵向增加收缩压和事件高血压。这表明PWV可以帮助识别血压正常的个体，这些个体应该成为实施旨在预防或延迟亚临床动脉硬化进展和高血压发作的干预措施的目标。
Objectives This study sought to evaluate whether pulse wave velocity (PWV), a noninvasive index of arterial stiffness, is a predictor of the longitudinal changes in systolic blood pressure (SBP) and of incident hypertension.Background Although arterial stiffness is believed to underlie, in part, the age-associated changes in SBP, particularly at older ages, few longitudinal studies in humans have examined the relationship between arterial stiffness and blood pressure.Methods Pulse wave velocity was measured at baseline in 449 normotensive or untreated hypertensive volunteers (age 53 +/- 17 years). Repeated measurements of blood pressure were performed during an average follow-up of 4.9 +/- 2.5 years.Results After adjusting for covariates including age, body mass index, and mean arterial pressure, linear mixed effects regression models showed that PWV was an independent determinant of the longitudinal increase in SBP (p = 0.003 for the interaction term with time). In a subset of 306 subjects who were normotensive at baseline, hypertension developed in 105 (34%) during a median follow-up of 4.3 years (range 2 to 12 years). By stepwise Cox proportional hazards models, PWV was an independent predictor of incident hypertension (hazard ratio 1.10 per 1 m/s increase in PWV, 95% confidence interval 1.00 to 1.30, p = 0.03) in individuals with a follow-up duration greater than the median.Conclusions Pulse wave velocity is an independent predictor of the longitudinal increase in SBP and of incident hypertension. This suggests that PWV could help identify normotensive individuals who should be targeted for the implementation of interventions aimed at preventing or delaying the progression of subclinical arterial stiffening and the onset of hypertension.