Objective To observe the effect of combination of antihypertensive and lipid lowering therapy on arterial stiffness in elderly patients with mild to moderate essential hypertension. Methods A total of 216 elderly patients with mild to moderate essential hypertension were enrolled and treated by hydrochlorothiazide as the basic therapy for two weeks. Then the patients were randomly divided into four groups. Namely, the intensified antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, Rosuvastatin 10 mg/d, n=54), the intensified antihypertensive treatment group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, n=54), the antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Rosuvastatin 10 mg/d, n=54), and the control group (hydrochlorothiazide 25 mg/d, n=54). After 12-month treatment, the blood pressure, blood lipid and carotid-radial pulse wave velocity (crPWV) of each group were recorded. Results Twelve months later, the SBP, DBP, PP and crPWV of each group were significantly lower than before (Plt;0.05). There was interactive effect of antihypertensive and lipid lowering therapy in lowering SBP, DBP, PP and crPWV (F=40.765, 4.869, 24.829, and 53.149, respectively, all Рlt;0.05). Conclusion The combination of antihypertensive and lipid lowering therapy can significantly lower the crPWV of elderly patients with hypertension and improve the arterial stiffness; it is superior to single treatment of either antihypertensive or lipid lowering.
目的 研究长期持续性心房颤动患者静息心率控制与脉搏波传导速度（PWV）的关系。 方法 序贯收集于2011年12月－2012年3月在四川大学华西医院心脏内科门诊就诊的长期持续性心房颤动患者84例，将人群按静息心率是否低于80次/min，分为标准组（心率＜80次/min）和对照组（心率≥80次/min），采用Pearson相关及多元线性回归分析方法，研究静息心率控制与PWV的关系。 结果 ①标准组人群的PWV显著低于对照组，而饮酒率显著高于对照组，差异皆有统计学意义（P＜0.05）。②Pearson相关分析显示静息心率与PWV存在线性相关关系（r=0.355，P=0.001）；多元线性回归分析显示，在调整了年龄、性别、BMI、收缩压、舒张压、吸烟、饮酒、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等混杂因素影响后，心率与PWV仍独立相关。 结论 长期持续性心房颤动患者的静息心率控制不良与PWV升高关系密切。
ObjectiveTo investigate the association between metabolic syndrome and arterial stiffness in elderly people. Methods1 599 participants aged over 65 years old were recruited from 10 communities located in the northern Shanghai. Carotid-femoral pulse wave velocity (cf-PWV) of each participant was measured by SphygmoCor device. Measurements for the diagnosis of metabolic syndrome were all investigated for each participant. SPSS 20.0 was used for data management and statistical analysis. ResultsCf-PWV was significantly associated with metabolic syndrome and its diagnostic measurements (P<0.001). Moreover, with the accumulating diagnostic measurements, cf-PWV increased gradually and significantly. The increasing trend remained significant in all participants, in men and in women (P<0.001). ConclusionArterial stiffness is significantly associated with metabolic syndrome and the accumulation of its diagnostic measurements.
ObjectiveTo investigate the association of arterial stiffness with cardiovascular risk factors. MethodsFrom July 2014 to August 2015, 1 599 participants aged over 65 years old were recruited from 10 communities located in the northern Shanghai. Carotid-femoral pulse wave velocity (cf-PWV) was measured by SphygmoCor device. Cardiovascular risk factors were assessed by questionnaire, anthropometry or conventional biochemical measurements. SPSS 20.0 was applied for data management and statistical analysis. ResultsCf-PWV was significantly associated with cardiovascular risk factors (P<0.001). Moreover, with the accumulating cardiovascular risk factors, cf-PWV increased gradually and significantly (P<0.001). The increasing trend remained significant in all participants, in men and in women, respectively. ConclusionArterial stiffness is significantly associated with cardiovascular risk factors and their accumulation.
Objective To explore the best mode of blood pressure monitoring by comparing the correlation of deferent kinds of blood pressure variability with arterial stiffness. Methods This study was conducted among 140 hypertensive patients in Wuhou Strict, Chengdu. Baseline data was collected including demographic data, biochemical examination and brachial-ankle pulse wave velocity (baPWV) measurement and so on. A consecutive home blood pressure was also gained by the individuals themselves and the clinical blood pressure was also recorded during the visit. The correlation between baPWV and the blood pressure variability were tested. Results The blood pressure variability measured at home in the morning was independently correlated with baPWV (r=0.313, P=0.011), the blood pressure variability measured at home in the evening was also independently correlated with baPWV (r=0.241, P=0.042), and day-to-day morning blood pressure variability measured at home was correlated with baPWV (r= 0.269, P=0.030). The correlation of month-to-month blood pressure variability and blood pressure variability gained at clinic room with baPWV was not significant (P>0.05). Conclusion In the monitoring of blood pressure variability in hypertensive patients, the blood pressure variability monitoring at home is better than that at the clinic room; and monitoring in the morning is better than that in the evening.
ObjectiveTo investigate the relationship between pulmonary ventilation function (obstructive and restrictive ventilation dysfunction) and atherosclerosis, and explore the correlation between brachial-ankle pulse wave velocity (ba-PWV, an effective index for evaluating atherosclerosis) and pulmonary ventilation function.MethodsFrom January to August 2018, a total of 6403 healthy subjects who reported no major chronic diseases such as stroke, myocardial infarction, cor pulmonale or malignant tumor were selected. Past history such as smoking history, hypertension, diabetes, blood biochemistry, and blood hypersensitive C reactive protein (hs-CRP), hemodynamic indexes such as systolic pressure, diastolic pressure and ba-PWV, body measurement indexes such as height, weight, waist circumference and pulmonary ventilation function were collected. The relationship between ba-PWV and pulmonary ventilation function were evaluated.ResultsA total of 2433 subjects were included, including 916 males and 1517 females. Ba-PWV showed significant positive correlations with age, smoking index, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, cholesterol, low density lipoprotein, hs-CRP, glycosylated hemoglobin, and significant negative correlations with height, percentage of forced vital capacity (FVC) in the predicted value (FVC%pred), forced expiratory volume in one second (FEV1), percentage of FEV1 in the predicted value (FEV1%pred), FEV1/FVC ratio and percentage of maximun midexpiratory flow (MMEF) in the predicted value (MMEF%pred). The ba-PWV was not correlated with weight, body mass index, FVC, MMEF, γ-glutamyl transpeptidase, high density lipoprotein, creatinine or uric acid. In multiple regression analysis using factors other than ba-PWV and respiratory function as adjustment variables, both FVC%pred and FEV1%pred showed significant negative relationships with ba-PWV (P<0.05).ConclusionsThe results indicate that FEV1/FVC, an indicator of airflow limitation, is not a predictor of ba-PWV. However, since ba-PWV showed significant negative relationship with FVC%pred and FEV1%pred, clinically assessment of arterial stiffness might be considered in individuals with impaired pulmonary ventilation.
ObjectiveTo evaluate the level of arteriosclerosis in patients with hypertension defined by the American Heart Association (AHA) and classical diagnostic criteria. MethodsA total of 3 815 residents were enrolled in 10 communities in north Shanghai. According to the classic diagnostic criteria of hypertension (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) and AHA diagnostic criteria (systolic blood pressure≥130 mmHg and/or diastolic blood pressure≥80 mmHg), the population was divided into normal blood pressure group, AHA diagnosis standard hypertension group, and classic methods of diagnosis of hypertension group. The differences in cervical-femoral pulse wave velocity (cf-PWV) and brachial-ankle pulse wave velocity (ba-PWV) among the three groups were compared. SPSS 13.0 software was then used for data analysis.ResultsCompared with the patients who met the standard criteria, patients who met AHA criteria had lower mean ages (70.2±7.4 vs. 71.4±7.9 year, P<0.001), more history of hypertension (48.8% vs. 72.7%, P<0.001) and lower body mass index (24.1±3.5 vs. 24.7±3.9 kg/m2, P<0.001), low-density lipoprotein (3.07±0.92 vs. 3.15±0.97 mmol/L, P=0.033), cf-PWV (8.7±2.7 vs. 9.8±3.0 m/s, P<0.001) and ba-PWV (1 647.7±610.1 vs. 1 797.2±729.7 cm/s, P<0.001). ConclusionsThe degree of arteriosclerosis of patients who meet AHA standards is between that who meet the standard criteria and the normal population. For these patients, blood pressure should be actively controlled to delay the progression of arteriosclerosis.