摘要： 目的·研究上海市社区中老年人群健康的血管衰老（healthy vascular aging，HVA）与心血管疾病患病风险的相关性。方法·对上海市嘉定社区9 922名40岁及以上常住居民进行问卷调查、体格检查、生化指标检测及臂-踝脉搏波传导速度（brachial-ankle pulse wave velocity，baPWV）测定。根据HVA状态，将受试者分为HVA组和非HVA组。HVA定义为无高血压病史且baPWV≤15.20 m/s。心血管疾病包括脑卒中、心肌梗死和冠状动脉粥样硬化性心脏病。采用Logistic回归模型分析HVA与心血管疾病患病风险的相关性。结果·在男性和女性中，与非HVA组相比，HVA组受试者的年龄、体质量指数、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、血肌酐、baPWV、糖尿病和血脂紊乱的患病率均较低，受教育程度（高中及以上）占比、估算的肾小球滤过率均较高（均
P=0.000）。Logistic回归分析表明，校正多种混杂因素后，HVA组的心血管疾病患病风险显著低于非HVA组（
OR=0.53，95%
CI 0.41~0.69，
P=0.000）。结论·在上海市社区40岁及以上的中老年人群中，HVA与较低的心血管疾病患病风险相关，提示其可作为心血管疾病预防的潜在指标。
关键词: 健康的血管衰老, 心血管疾病, 中老年人群 Abstract: Objective·To study the correlation between healthy vascular aging (HVA) and prevalent cardiovascular diseases (CVDs) risk in middle-aged and elderly people in the community of Shanghai.
Methods·A total of 9 922 participants aged 40 and above who lived in a Jiading community of Shanghai were included. The questionnaire interview, physical examination, biochemical index detection and brachial-ankle pulse wave velocity (baPWV) measurement were conducted in all participants. According to HVA status, the participants were divided into HVA group and non-HVA group. HVA was defined as baPWV≤15.20 m/s with no history of hypertension. The CVDs include stroke, myocardial infarction and coronary atherosclerotic heart disease. Logistic regression model was used to analyze the correlation between HVA and prevalent CVDs risk.
Results·Compared with those in the non-HVA group, the age, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, serum creatinine, baPWV and prevalence of diabetes mellitus and lipid disorders in the HVA group were lower, and the proportion of education level (high school or above) and estimated glomerular filtration rate in the HVA group were higher in both men and women (all P=0.000). Logistic regression analysis showed that after multiple confounding factors being adjusted, prevalent CVDs risk in the HVA group was significantly lower than that in the non-HVA group (OR=0.53, 95%CI 0.41?0.69, P=0.000).
Conclusions·HVA is significantly associated with a lower risk of CVDs in middle-aged and elderly people (aged≥40) in the community of Shanghai, which suggests that HVA can be used as a potential indicator of CVDs prevention.
Key words: healthy vascular aging (HVA), cardiovascular disease (CVD), middle-aged and elderly people PDF全文下载地址:
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