Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion: SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.
目的： 探讨血压对不同年龄人群动脉僵硬度的影响。 方法： 以既参加了2010、2012和2014年健康体检又检测了臂踝脉搏波传导速度（baPWV）的开滦集团在职及退休人员为研究对象。根据世界卫生组织的年龄划分标准将研究对象分为3组，即18~44岁组、45~59岁组和≥60岁组。根据中国高血压防治指南2010中高血压的诊断标准将研究对象分为非高血压人群和高血压人群。baPWV是评估动脉硬化程度的敏感指标,本研究以baPWV代表动脉僵硬度。采用多元线性回归分析总人群收缩压（SBP）与baPWV的关联，并进一步采用多元线性回归分析不同年龄组人群SBP与baPWV的关联。采用多因素logistic回归模型分别分析总人群血压和不同年龄组人群血压对动脉硬化（baPWV≥1 400 cm/s）的影响。 结果： （1）研究对象的一般情况：同时完成2010、2012和2014年健康体检并检测了baPWV的职工共35 350名，排除血压值缺失者2 237名，排除外周血管疾病患者1 569例，排除检测baPWV之前有心脑血管病史者1 016例，最终入选研究对象29 367名。29 367名研究对象的年龄为（48.0±12.4）岁，其中男性21 305名（72.5%）。根据年龄将研究对象分为3组，其中18~44岁组11 608名（39.53%）、45~59岁组12 757名（43.44%）、≥60岁组5 002名（17.03%）。（2）不同年龄组人群baPWV的分布情况:baPWV随着年龄的增加而增加，非高血压组18~44岁、45~59岁和≥60岁亚组人群baPWV的均数依次为1 299.3、1 428.7和1 704.6 cm/s（P<0.001），高血压组18~44岁、45~59岁和≥60岁亚组人群baPWV的均数依次为1 498.4、1 640.7和1 921.4 cm/s（P<0.001）。高血压组人群baPWV高于非高血压组同年龄亚组（P均<0.05）。（3）baPWV相关因素的多元线性回归分析结果：以baPWV为因变量，以SBP为自变量，校正了年龄、性别、脉压差（PP）、体重指数（BMI）、空腹血糖（FBG）、总胆固醇（TC）、吸烟、饮酒、体育锻炼、服降压药、服调脂药等混杂因素后，多元线性回归分析结果显示，在总人群中，SBP与baPWV呈线性正相关（t=39.30，P<0.001）。进一步在18~44岁组、45~59岁组和≥60岁组人群中发现SBP与baPWV均呈线性正相关（t分别为37.72、27.30、9.15，P均<0.001）。（4）baPWV影响因素的多因素logistic回归分析结果：以baPWV为因变量（baPWV<1 400 cm/s赋值为1，≥1 400 cm/s赋值为2），以血压为自变量（非高血压赋值为1，高血压赋值为2），校正了年龄、性别、PP、BMI、FBG、TC、吸烟、饮酒、体育锻炼、服降压药、服调脂药物等混杂因素后结果显示，在总人群中，高血压人群发生动脉硬化的风险高于非高血压人群（OR=2.54，95%CI 2.35~2.74）；在18~44岁组、45~59岁组和≥60岁组人群中，高血压人群发生动脉硬化的风险均高于非高血压人群（分别为OR=3.22，95%CI 2.86~3.63；OR=2.48，95%CI 2.23~2.76；OR=1.91，95%CI 1.42~2.56）。 结论： SBP与不同年龄组人群的动脉僵硬度呈线性正相关，且高血压是不同年龄组人群发生动脉硬化的危险因素。临床试验注册中国临床试验注册中心，ChiCTR-TNC-11001489。.
Keywords: Age factors; Arteriosclerosis; Blood pressure; Brachial ankle pulse wave velocity.