Hypertension:高血压对于长期高体重指数和动脉硬化之间的介导效应

2018-12-04 国际循环编辑部 国际循环

肥胖和高血压是动脉硬化的重要危险因素,然而,体重指数(BMI)增加,血压升高(BP)和动脉硬化的复杂关系在很大程度上尚未可知。Yang Liu等研究者发表于Hypertension的一项研究,目的是探讨升高的BP对中年人早期BMI、BMI长期增加及其与动脉硬化趋势关系的介导作用。

肥胖和高血压是动脉硬化的重要危险因素,然而,体重指数(BMI)增加,血压升高(BP)和动脉硬化的复杂关系在很大程度上尚未可知。Yang Liu等研究者发表于Hypertension的一项研究,目的是探讨升高的BP对中年人早期BMI、BMI长期增加及其与动脉硬化趋势关系的介导作用。

纵向队列研究包括1190名参与者(829名白人和361名黑人,518名男性,平均随访年龄为40.0岁),他们从儿童时期检查BMI和BP 4~15次,成年期检查主动脉-股动脉脉搏波速度(afPWV),平均随访期为30.3年。应用随机效应模型计算曲线下总面积(AUCt)和增量AUC(AUCi),并用作BMI和BP的长期测量值。对协变量校正的BMI检查对成人afPWV的总效应在无BMI和收缩压(SBP)测量值的模型中均显著。

成人SBP(20.2%)和SBP AUCi(16.9%)的作用对儿童BMI-afPWV的关联有显著影响。成人SBP显示,其对BMI AUC1-afPWV关联的显著调节作用达36.7%和对BMI AUCt-afPWV关联的显著调节作用达36.4%。SBP AUCi对BMI AUCi-afPWV关联的介导效应达63.3%(P<0.01)。舒张压具有相似的总体和介导效应。

上述研究结果表明,afPWV测量的儿童BMI增加与其累积负荷成人动脉硬化程度的关系主要通过BP的长期升高趋势来介导。

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