杜鑫，刘妍，张莹，施继红，黄喆，朱辰蕊，李慧英，魏晓明，林黎明，熊海亮，季春鹏，吴寿岭



中老年人群心血管健康指标变化与动脉僵硬度的关系

杜鑫，刘妍，张莹，施继红，黄喆，朱辰蕊，李慧英，魏晓明，林黎明，熊海亮，季春鹏，吴寿岭

摘要

关键词心血管系统；健康状况；动脉僵硬度

作者单位：063000 河北省唐山市，开滦总医院 心内二科（杜鑫、刘妍、施继红、黄喆、朱辰蕊、李慧英、魏晓明、林黎明、熊海亮、季春鹏、吴寿岭）；华北理工大学附属医院 超声科（张莹）

Relationship Between the Changes of Cardiovascular Health Indicator and Arteriosclerosis in Middle and Elder Population

DU Xin, LIU Yan, ZHANG Ying, SHI Ji-hong, HUANG Zhe; ZHU Chen-rui, LI Hui-ying, WEI Xiao-ming, LIN Li-ming, XIONG Hai-liang, JI Chun-peng, WU Shou-ling.
Department of Cardiology Second Unit, Kailuan General Hospital, Tangshan (063000), Hebei, China
Corresponding Author: WU Shou-ling, Email: drwusl@163.com

Abstract

Objective: To investigate the changes of cardiovascular health indicator and arteriosclerosis in middle and elder population.

Methods: A total of 4190 subjects with the average age of (49.78 ± 9.74) years by 3 physical examinations in Kailuan group from 2006 to 2011 were randomly stratified for arm ankle arterial pulse wave velocity (baPWV) examination.According to 7 AHA cardiovascular health indicators of non-smoking, normal BMI, active excise, healthy diet, normal cholesterol, blood pressure and fasting blood glucose, each indicator had 3 conditions as ideal, general and poor by scores of 2, 1 and 0 respectively.Based on the 1stand 3rdphysical examinations, the changes of cardiovascular health scores (△CHS), the subjects were divided into 8 groups as △CHS ≤ -4, -3, -2, -1, 0, 1, 2 and △CHS≥ 3, n=241, 368, 611, 855, 911, 647, 354 and 203 respectively.The impacts of △CHS on baPWV values were studied by liner and Logistic regression analyses.

Results: As△CHS increased by △CHS ≤ -4, -3,-2,-1,0,1, 2 and△CHS ≥ 3, the baPWV values were decreased accordingly by cm/s as (1590.78 ± 17.93), (1566.4 ± 14.5), (1552.83 ± 11.25), (1536.59 ± 9.51), (1508.85 ± 9.21), (1499.81 ± 10.93), (1485.92 ± 14.82) and (1475.85 ± 19.57) respectively.Multiple linear regression analysis showed thatwith adjusted confounding factors, as△CHS increasing 1 score, baPWV increasing 15.58 cm/s (B=15.58, P<0.001).Logistic regression analysis indicated that with adjusted confounding factors, as △CHS increasing 1 score, the risk for arteriosclerosis occurrence was decreased by 14% (OR=0.86, 95% CI 0.83-0.90).

Conclusion:△CHS was negatively related to baPWV in middle and elder subjects, improving cardiovascular health indicator may decrease arteriosclerosis occurrence.

Key words Cardiovascular system; State of health; Arteriosclerosis

(Chinese Circulation Journal, 2016,31:137.)

为促进心血管健康、降低心血管疾病发病风险，美国心脏协会（AHA）提出了7项心血管健康指标（不吸烟、正常体重指数、积极体育锻炼、健康饮食、正常胆固醇水平、正常血压水平、正常空腹血糖水平），并将每项指标分为理想、一般、差3等级[1]。此后，越来越多研究表明：理想心血管健康指标对心、脑血管具有保护作用[2-7]。但理想心血管健康指标分布情况，并未因其保护作用而流行。相反，国内外理想心血管健康指标所占比例均非常低[1, 8]。目前，Huffman等[9]研究证实：若按此流行趋势发展，至2020年AHA心血管健康指标改善20%的目标难以实现。故心血管健康指标改善日益成为人们关注重点。Aatola等[10]对儿童和青年人群心血管健康指标改善进行研究，结果发现：从儿童到成年、从青年到中年期间理想心血管健康变化是成年时动脉僵硬的独立预测因子。目前，有关中老年人群心血管健康指标改善对动脉僵硬度的意义却鲜有报道。故我们依据开滦研究（注册号：ChiCTR-TNC-11001489）和国家科技重大专项课题（2008ZX09312-008-004）的资料，分析了中老年人群心血管健康指标变化对动脉僵硬度的影响。……