背景:在普通人群中,关于心-踝血管指数(CAVI)与夜间血压(BP)下降程度之间的关联的研究结果很少。我们试图在PressioniMonitorateELoroAssociazioni(PAMELA)研究的参与者中调查这一问题。
方法:该研究包括491名参与者,他们参加了从初始评估开始10年和25年后进行的PAMELA研究的第二次和第三次调查。数据收集包括病史,人体测量参数,office,home,动态血压血压监测(ABPM),血液检查,超声心动图,和CAVI测量。
结果:在整个研究中,CAVI和左心室质量指数(LVMI)与夜间SBP下降呈负相关,表示为昼夜百分比变化(分别为r=-0.152,p=0.0007和r=-0.213,p<0.0001)。然而,在调整了性别和年龄后,仅LVMI的相关性仍然显著(r=-0.124,p=0.006).非北斗星参与者表现出明显更高的性别年龄调整LVMI(91±22vs82±18g/m2(p<0.0001)),而不是CAVI(9.07±2.0和9.57±2.2m/s,p=ns)。当将参与者分类为夜间SBP下降的四分位数时,发现了类似的结果。最后,性别年龄校正CAVI和LVMI均与平均夜间SBP呈正相关(r=0.181,p<0.001,r=0.240,p<0.0001)。
结论:尽管通过CAVI评估动脉僵硬度,不像LVMI,与夜间血压下降的程度无关,该标记可用于识别夜间高血压和优化社区心血管危险分层.
BACKGROUND: Findings regarding the association between Cardio-Ankle Vascular Index (CAVI) and the extent of nocturnal blood pressure (BP) fall in the general population are scanty. We sought to investigate this issue in the participants enrolled in the Pressioni Monitorate E Loro Associazioni (PAMELA) study.
METHODS: The study included 491 participants who attended the second and third surveys of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, office, home, ambulatory blood pressure BP monitoring (ABPM), blood examinations, echocardiography, and CAVI measurements.
RESULTS: In the whole study, both CAVI and left ventricular mass index (LVMI) were inversely correlated with nocturnal SBP fall, expressed as day-night percent change (r = - 0.152, p = 0.0007, and r = - 0.213, p < 0.0001, respectively). However, after adjustment for sex and age, the correlation remained significant only for LVMI (r = - 0.124, p = 0.006). Non-dipper participants exhibited significantly higher sex-age adjusted LVMI (91 ± 22 vs 82 ± 18 g/m2 (p < 0.0001)), but not of CAVI (9.07 ± 2.0 and 9.57 ± 2.2 m/s, p = ns). Similar results were found when classifying participants into quartiles of nocturnal SBP drop. Finally, both sex-age adjusted CAVI and LVMI were positively correlated with mean nocturnal SBP (r = 0.181, p < 0.001, and r = 0.240, p < 0.0001).
CONCLUSIONS: Although arterial stiffness assessed by CAVI, unlike LVMI, is unrelated with the degree of nocturnal BP drop, this marker is useful in identifying nocturnal hypertension and optimizing cardiovascular risk stratification in the community.