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Abstract：
Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03-1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37-1.89, p < .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .
摘要：
尽管人们已经认识到持续性高血压与微循环和宏循环功能受损之间的联系，在探索微血管和大血管损伤之间相互作用的定量研究中仍然存在显著差距.在这项研究中,作者研究了成人高血压患者臂踝脉搏波传导速度(baPWV)与高血压视网膜病变之间的关系.作者对接受治疗的高血压患者进行了横断面研究，最后一次随访数据来自2013年中国斯托克一级预防试验（CSPPT）。随着PWV/ABI仪器的使用，自动测量baPWV。Keith-Wagener-Barker分类用于确定高血压视网膜病变的诊断。使用多变量逻辑回归模型确定baPWV与高血压视网膜病变之间联系的比值比（OR）和95％置信区间（CI）。使用多变量调整的受限三次样条模型创建OR曲线，以研究baPWV和高血压视网膜病之间的任何潜在非线性剂量反应关系。11,279名参与者中共有8514名（75.5％）被诊断为高血压视网膜病变。高血压视网膜病变的患病率从baPWV的底部四分位数增加到顶部四分位数:四分位数1:70.7%,四分位数2：76.1%，四分位数3：76.7%，四分位数4：78.4%。在调整了潜在的混杂因素后，baPWV与高血压视网膜病变呈正相关(OR=1.05,95%CI,1.03-1.07,p<.001)。与baPWV最低四分位数相比，baPWV四分位数最高的患者患高血压视网膜病变的比值比为1.61(OR=1.61,95%CI:1.37-1.89,p<.001).两分段逻辑回归模型表明baPWV与高血压视网膜病变之间存在非线性关系，拐点为17.1m/s，高于该拐点时效果已饱和。
