缺乏认可的女性心血管风险增强剂:呼吁重新思考对风险分层的临床评估
Albertina M Ghelfi1,2,3, Gustavo J Staffieri3,4, Mildren A Del-Sueldo3,5
1Unidad de Hipertensión Arterial y Riesgo Cardiovascular, Hospital Escuela Eva Perón. Granadero Baigorria, Santa Fe, Argentina.
American journal of preventive cardiology
|March 10, 2025
概括
患有心血管风险增强剂 (CVRE) 的女性增加了动脉硬度 (AS),由更高的脉冲波速度 (PWV) 表明. 这凸显了在女性心血管健康评估中考虑CVRE的必要性.
科学领域:
- 心血管医学 心血管医学
- 血管生理学 血管生理学
- 妇女健康 妇女健康
背景情况:
- 传统的心血管风险分层 (CVR) 往往忽略了心血管风险增强剂 (CVRE).
- 妇女可能有未被认可的CVRE,导致动脉硬 (AS),这是心血管疾病的前体.
- 动脉硬度,通过带-大腿脉冲波速率 (cf-PWV) 测量,是血管健康的关键指标.
研究的目的:
- 为了确定cf-PWV值,并评估低CVR但存在CVRE的女性的AS.
- 为了比较CVRE和对照组的女性之间的cf-PWV和AS.
- 为了研究CVRE和女性动脉硬之间的关系.
主要方法:
- 在阿根廷进行的多中心横截面研究 (2022-2024).
- 包括280名女性 (18-59岁) 具有较低的传统CVR (10年风险<5%),并控制血压.
- 第1组 (N=174) 患有CVRE (例如,有妊娠前史,自身免疫性疾病,瘤治疗,堕胎,早期更年期,情绪障碍,艾滋病毒). 第二组 (N=106) 是对照组.
- 排除标准包括高血压,糖尿病,目标器官损伤,慢性病,目前吸烟,以前的心血管事件和特定药物.
主要成果:
- 与对照组相比,患有CVRE (1组) 的女性表现出明显更高的cf-PWV (7.02±1.20对比5.71±0.86,p < 0.0001) 和更高的AS频率 (52.9%对比0.9%,p < 0.0001).
- 在更严格控制血压的女性 (<130/85 mmHg办公室BP,<121 mmHg中央心血压) 的亚分析证实,CVRE组中cf-PWV (6.70±1.07对比5.62±0.78,p < 0.0001) 和AS (43.4%对比0.0%,p < 0.0001) 较高.
- 多变量分析证实,cf-PWV值与CVRE存在有显著关系 (p < 0.0001).
结论:
- 患有心血管风险增强剂 (CVRE) 的女性表现出显著增加的动脉硬性 (AS).
- 患有CVRE的女性中较高的cf-PWV值强调了这些因素对血管健康的重要性.
- 这些发现表明,CVRE应纳入女性心血管风险评估.
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