Arterial Stiffness Is Associated With Carotid Atherosclerosis in Hypertensive Patients (The Campania Salute Network)
Arterial Stiffness Is Associated With Carotid Atherosclerosis in Hypertensive Patients (The Campania Salute Network)
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DOI：
10.1038/ajh.2012.38
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发表时间：
2012-07-01
影响因子：
3.2
通讯作者：
De Luca, Nicola
中科院分区：
文献类型：
--
作者：
Casalnuovo, Giuseppina;Gerdts, Eva;De Luca, Nicola
背景脉压/每搏输出量高度指数(2.04)(PP/SVI)是动脉僵硬的有效指标，但其与颈动脉粥样硬化的关系尚不清楚。方法分析Campania Salote Network中6209例高血压患者的临床、超声心动图和颈动脉超声数据。种群被划分为PP/SVI的三分位数。颈动脉超声显示颈总动脉和颈内动脉的峰值和平均内中膜厚度(IMT)以及颈动脉斑块的存在。结果PP/SVI比值的增加与年龄、血压、血清总胆固醇和降压药物用量的增加平行相关(均P<；0.01)。在调整了年龄、性别、血压、血脂和糖尿病后，PP/SVI也与更大的峰值和平均IMT相关(均P<；0.01)。同样，与低PP/SVI三分位数相比，颈动脉斑块的多重调整患病率在中三分位数为7(95%可信区间1-13，P&t；0.03)，在上三分位数为21(95%可信区间15-28，P<；0.0001)，与混杂因素无关。结论：在参加Campania Salote网络的接受治疗的高血压患者中，较高的PP/SVI与颈动脉粥样硬化有关，与众所周知的临床混杂因素无关。
BACKGROUNDPulse pressure/stroke volume indexed to height(2.04) (PP/SVi) is a validated measure of arterial stiffness, but its relation to carotid atherosclerosis is unknown.METHODSClinical, echocardiographic, and carotid ultrasound data from 6,209 hypertensive patients without prevalent cardiovascular (CV) disease in the Campania Salute Network were analyzed. The population was grouped into tertiles of PP/SVi. From carotid ultrasound, peak and mean intima-media thickness (IMT) and presence of carotid plaques in the common and internal carotid arteries were reported.RESULTSIncreasing PP/SVi tertile was associated with a parallel increase in age, blood pressure, total serum cholesterol and the number of antihypertensive drugs used (all P < 0.01). Higher PP/SVi was also associated with greater peak and mean IMT (all P < 0.01), also when adjusting for age, gender, blood pressure, lipid profile, and diabetes mellitus (all P < 0.01). Similarly, compared to the lower PP/SVi tertile, the multiple adjusted prevalence ratio of carotid plaque was 7(95% confidence interval (CI) 1-13, P < 0.03) in the middle tertile and 21 (95% CI 15-28, P < 0.0001) in the upper tertile, independently of confounders.CONCLUSIONIn treated hypertensive patients participating in the Campania Salute Network, higher PP/SVi is associated with carotid atherosclerosis independent of well-known clinical confounders.