Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan
Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan
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DOI：
10.1161/01.str.0000259604.67283.69
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发表时间：
2007-04-01
期刊：
影响因子：
8.3
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Kikuya, Masahiro;Staessen, Jan A.;Imai, Yutaka
背景和目的：动态动脉硬化指数（AASI）和脉压（PP）是动脉硬化的指标，可以通过24小时血压记录计算。我们研究了AASI和PP与死亡结局的预后价值。（基线年龄，40至93岁; 63.4%的女性），我们应用考克斯回归将死亡率与AASI和PP相关，同时调整性别、年龄、BMI、24小时MAP、吸烟和饮酒习惯、糖尿病，结果：在13.3年（中位数）期间，发生了126例心血管死亡和63例中风死亡。四分位数的心血管和卒中死亡率的性别和年龄标准化发生率在AASI中呈U形，在PP中呈J形。在四分位数中，AASI的心血管和卒中死亡的多变量校正风险比以U形方式显著偏离整个人群，而PP的HR均未偏离总体风险。AASI四分位数上升组的心血管死亡风险比分别为1.40（P = 0.04）、0.82（P = 0.25）、0.64（P = 0.01）和1.35（P = 0.03）。额外的调整AASI PP和敏感性分析的性别，排除患者抗高血压治疗或心血管疾病史，或审查死亡发生在2年内的enrollment. Conclusions，在日本人口，AASI预测心血管和中风死亡率超过PP和其他危险因素，而在调整后的分析，PP没有携带任何预后信息。
Background and Purpose-Ambulatory arterial stiffness index (AASI) and pulse pressure (PP) are indexes of arterial stiffness and can be computed from 24-hour blood pressure recordings. We investigated the prognostic value of AASI and PP in relation to fatal outcomes.Methods-In 1542 Ohasama residents (baseline age, 40 to 93 years; 63.4% women), we applied Cox regression to relate mortality to AASI and PP while adjusting for sex, age, BMI, 24-hour MAP, smoking and drinking habits, diabetes mellitus, and a history of cardiovascular disease.Results-During 13.3 years (median), 126 cardiovascular and 63 stroke deaths occurred. The sex- and age-standardized incidence rates of cardiovascular and stroke mortality across quartiles were U-shaped for AASI and J-shaped for PP. Across quartiles, the multivariate-adjusted hazard ratios for cardiovascular and stroke death significantly deviated from those in the whole population in a U-shaped fashion for AASI, whereas for PP, none of the HRs departed from the overall risk. The hazard ratios for cardiovascular mortality across ascending AASI quartiles were 1.40 (P = 0.04), 0.82 (P = 0.25), 0.64 (P = 0.01), and 1.35 (P = 0.03). Additional adjustment of AASI for PP and sensitivity analyses by sex, excluding patients on antihypertensive treatment or with a history of cardiovascular disease, or censoring deaths occurring within 2 years of enrollment, produced confirmatory results.Conclusions-In a Japanese population, AASI predicted cardiovascular and stroke mortality over and beyond PP and other risk factors, whereas in adjusted analyses, PP did not carry any prognostic information.