Hypertension:青年长期血压变异性与中年冠状动脉钙化和颈动脉内膜中层厚度的关系

2020-06-30 MedSci原创 MedSci原创

成年早期的长期收缩压和舒张压BP变异性与颈动脉内膜中层厚度的不良中年改变呈正相关,但与CAC无关。该研究的结果为长期BP变异性与心血管疾病之间关联的病理生理机制提供了进一步的见解。

最近的证据表明长期(就诊)血压(BP)变异性与血管疾病风险之间存在关系,而与平均BP水平无关。长期BP变异性与心血管疾病风险之间的潜在关联可能反映在早期生命过程中冠状动脉钙(CAC)和颈动脉内膜中膜厚度的改变。

近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员评估了2482名CARDIA研究(年轻人冠状动脉风险发展)参与者([2005-2006]的平均[SD]年龄为45.4[3.6]岁,男性为43.2%,黑人为41.3%)。研究人员纳入了经过20年(0、2、5、7、10、15、20年评估)BP评估的参与者,并在20年评估中对颈动脉内膜中层厚度和CAC数据进行了分析。研究人员使用独立于均值和SD的变异性评估BP变异性。调整后的多元线性或logistic回归模型用于评估长期BP变异性与颈动脉内膜中膜厚度和CAC之间的关联。

独立于平均值(每1个SD)的长期收缩压变异性与颈动脉内膜中层厚度之间呈正相关(β=10μm,SE=3,P=0.002)。同样,独立于平均值的长期舒张压BP变异性与颈动脉内膜-中膜厚度有关(β=10μm,SE=3,P=0.001)。长期BP变异性与CAC无关。

由此可见,成年早期的长期收缩压和舒张压BP变异性与颈动脉内膜中层厚度的不良中年改变呈正相关,但与CAC无关。该研究的结果为长期BP变异性与心血管疾病之间关联的病理生理机制提供了进一步的见解。

原始出处:

Chike C. Nwabuo.et al.Long-Term Blood Pressure Variability in Young Adulthood and Coronary Artery Calcium and Carotid Intima-Media Thickness in Midlife The CARDIA Study.Hypertension.2020.https://www.ahajournals.org/toc/hyp/0/0

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  5. 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伸指一数,促进冠状动脉钙化的因素好像很多。近期阜外医院血脂异常与心血管病中心李建军、曹晔萱等进行的研究则提示,血浆前蛋白转化酶枯草杆菌蛋白酶kexin 9 型(PCSK9)对冠状动脉钙化具有潜在的促进作用。

Diabetes Care:升高的TyG指数预测冠状动脉钙化进展

由此可见,TyG指数是CAC进展的独立预测因子。

Circulation:对于普通健康中年男性,心肺适应性越好,心血管意外风险越低

一篇极具说服力的文献表明冠状动脉钙化(CAC)和心肺适应性(CRF)都是心血管疾病(CVD)事件的独立预测因子。但目前我们对CRF和CAC关于CVD风险的相互联系知之甚少。CAC高时,CRF高相比CRF低与CVD事件减少相关。Nina B. Radford等人故开展一项研究,在CAC负担增加的背景下,对CRF持续水平对CVD风险的影响进行评估。研究人员共研究了8425位无临床CVD的男性,其于19

Atherosclerosis:低风险青年血压升高导致CAC负荷增加

在线发表于《atherosclerosis》杂志上的一项研究表明,即使是10年CVD风险处于低危的年轻人群,其较高的血压类别与较高的冠状动脉钙化(CAC)评分呈正相关。

Hypertension:血清醛固酮浓度与血压和冠状动脉钙化的关系

较高的醛固酮水平与亚临床冠状动脉粥样硬化和全因死亡率增加的风险相关,尤其是当肾素被抑制时。该研究的结果表明,醛固酮水平(即使在参考范围内)对于心血管系统和整体健康也很重要。

Med Sci Sports Exerc:马拉松男子运动员与冠状动脉钙化

长期跑马拉松的男子冠状动脉钙化(CAC)评分增加与心血管风险是否存在相关性尚不清楚。近期发表的一项最新研究就此问题进行了探讨。