国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
The Product of Resting Heart Rate Times Blood Pressure Is Associated with High Brachial-Ankle Pulse Wave Velocity
第一作者：Anxin Wang,Jie Tao
基本信息
- 负责人：Anxin Wang,Jie Tao
- 数据来源： APAC
- 论文编号：APAC20190075
- 发表时间：2014-09-16
2014-09-16
已发表文章
主要研究背景及目的
Brachial-ankle pulse wave velocity (baPWV) is an index of arterial stiffness and a marker of atherosclerosis that can be measured noninvasively. It has been shown to be an independent predictor of all-cause and cardiovascular mortality as well as an indicator for cardiovascular diseases. With the increasing use of baPWV in clinical practice as measure of arterial stiffness, the importance of understanding its associations with other cardiovascular factors has increased. Although the mechanisms responsible for arterial stiffening have not conclusively been explored yet, it has been discussed that arterial stiffness may be due to structural changes in the tunica media of the arteries. Based on mechanical considerations, one may postulate that these changes, including fatigue fracture of elastin, are correlated with the cyclic stress caused by the frequency and amount of pulsesynchronous blood pressure fluctuations. Accordingly, previous studies demonstrated that an elevated resting heart rate (RHR) was an independent risk factor for arterial stiffness. We now put forward the hypothesis that in addition to pulse rate and independently of other cardiovascular risk factors, the product of pulse rate multiplied with blood pressure would be correlated with baPWV as a measure of arterial stiffness. We therefore conducted this study to examine the association between the blood pressure heart rate product and the baPWV in the asymptomatic polyvascular abnormalities community study (APAC).
方法
The community-based ‘‘Asymptomatic Polyvascular Abnormalities in Community (APAC) Study’’ examined asymptomatic polyvascular abnormalities in a general Chinese population and included participants with an age of 40+ years without history of stroke and coronary heart disease. Arterial stiffness was defined as baPWV$1400 cm/s. We measured and calculated the product of resting heart rate and systolic blood pressure (RHR-SBP) and the product of resting heart rate and mean arterial pressure (RHR-MAP).
结论
Higher baPWV as a marker of arterial stiffness was associated with a higher product of RHR-SBP and RHR-MAP in multivariate analysis. In addition to other vascular risk factors, higher resting heart rate in combination with higher blood pressure are risk factors for arterial stiffness.
主要结果
The study included 5153 participants with a mean age of 55.1±11.8 years. Mean baPWV was 15866400 cm/s. Significant (P,0.0001) linear relationships were found between higher baPWV and higher resting heart rate or higher arterial blood pressure, with the highest baPWV observed in individuals from the highest quartiles of resting heart rate and blood pressure. After adjusting for confounding parameters such as age, sex, educational level, body mass index, fasting blood concentrations of glucose, blood lipids and high sensitive C-reactive protein, smoking status and alcohol consumption, prevalence of arterial stiffness increased significantly (P,0.0001) with increasing RHR-SBP quartile (Odds Ratio (OR): 2.72;95%Confidence interval (CI):1.46,5.08) and increasing RHR-MAP (OR:2.10;95%CI:1.18,3.72). Similar results were obtained in multivariate linear regression analyses with baPWV as continuous variable.