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[Characteristics and related risk factors of arterial elasticity in prehypertensive persons]
Yang Xi1, Ning-ling Sun, Zhi-ming Zhu
1Heart Center, Peking University People's Hospital, Beijing 100044, China.
Insights
Arterial elasticity declines in prehypertension, with blood pressure being a key risk factor. Combined risk factors like high-normal lipids or glucose further impact vascular function.
Area of Science:
- Cardiovascular physiology
- Vascular biology
- Hypertension research
Context:
- Prehypertension is a critical stage preceding established hypertension.
- Subclinical alterations in vascular function may precede overt disease.
- Understanding risk factors in this population is crucial for early intervention.
Purpose:
- To investigate arterial elasticity characteristics in individuals with prehypertension.
- To identify related risk factors, including high-normal blood lipids and impaired glucose regulation.
- To assess the impact of combined risk factors on vascular parameters.
Summary:
- Systemic vascular compliance (SVC), systemic vascular resistance (SVR), and brachial artery distensibility (BAD) were measured in 1238 participants.
- Individuals with prehypertension showed reduced SVC and BAD, and increased SVR compared to healthy controls.
- Blood pressure emerged as an independent risk factor for arterial elasticity, more so than lipid or glucose levels.
Impact:
- Vascular function is compromised even at the prehypertensive stage.
- Early identification and management of elevated blood pressure are vital.
- Combined cardiovascular risk factors at high-normal levels may synergistically impair vascular health.
Objective:
To explore the characteristics and related risk factors of arterial elasticity in persons with prehypertension, high-normal blood lipid and(or) impaired glucose regulation(impaired fasting glucose and(or) impaired glucose tolerance).
Methods:
After receiving physical and biochemical examinations, a total of 1238 persons were enrolled. Among them, the etiologies were prehypertension (n = 65), high-normal blood lipid (n = 156), impaired glucose regulation (n = 159), prehypertension and high-normal blood lipid (n = 85), prehypertension and impaired glucose regulation (n = 77), high-normal blood lipid and impaired glucose regulation (n = 55) and prehypertension, high-normal blood lipid and impaired glucose regulation (n = 9). Also 332 healthy subjects, 113 hypertensive patients, 150 hyperlipidemics and 37 diabetics were enrolled as controls. Systemic vascular compliance (SVC), systemic vascular resistance (SVR), brachial artery distensibility (BAD) were measured with Dynapulse 200 M (Pulse Metric, Inc., USA).
Results:
In persons with prehypertension, SVC was lower than healty group ((1.14 ± 0.20) ml vs (1.26 ± 0.23) ml, P < 0.01)and higher than hypertensive group ((1.11 ± 0.18) ml, P = 0.011), SVR higher than healty group (157 ± 29) kPa×s×L(-1) vs (148 ± 25) kPa×s×L(-1), P = 0.012) and lower than hypertensive group ((166 ± 36) kPa×s×L(-1), P < 0.01)and BAD lower than healty group(5.93% ± 1.14% vs 6.50% ± 1.30%, P < 0.01). Among different groups with prehypertension, high-normal blood lipid and(or) impaired glucose regulation, SVC, SVR and BAD had significant differences. As indicated by multiple linear regression analysis, blood pressure was an independent risk factor of arterial elasticity.
Conclusions:
Vascular function becomes damaged in prehypertensive stage. As an independent risk factor, blood pressure had more potent effect than lipid and blood glucose. Multiple cardiovascular risk factors with high-normal value may affect vascular function more strongly.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Hypertension III: Clinical Manifestations and Diagnostic Studies
