青春期的血压和中年人的动脉样硬化
Ángel Herraiz-Adillo1, Hampus Eriksson1,2, Viktor H Ahlqvist3,4
1Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
JAMA cardiology
|November 19, 2025
概括
青少年血压升高与中年冠状动脉样硬化的增加有关. 即使是高血压,根据最近的指导方针,也显示出这种心血管疾病的风险过高.
科学领域:
- 心血管科学 心血管科学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 青春期血压升高是未来心血管疾病 (CVD) 死亡率和动脉样硬化的已知危险因素.
- 传统的标志物,如动脉内膜厚度和冠状动脉化,可能不能完全代表亚临床心血管疾病的谱.
研究的目的:
- 为了调查青少年的缩和腹缩血压与中年动脉样硬化存在之间的联系.
- 使用冠状动脉计算机断层扫描血管学 (CCTA) 进行精确的动脉样硬化测量.
主要方法:
- 瑞典的一项基于人口的队列研究将青少年BP数据 (1972-1987) 与中年CCTA数据 (2013-2018) 联系起来.
- 青少年BP被使用2025年ACC/AHA和2024年ESC指南进行分类.
- 多项逻辑回归,调整的流行率和受限制的立方线分析了与冠状动脉狭窄的关联.
主要成果:
- 这项研究包括10,222名男性,研究时间中位数为39.5年.
- 青少年血压升高显示了与冠状动脉狭窄的剂量反应相关性,特别是严重的狭窄 (≥50%).
- 青春期2期高血压与严重冠状动脉狭窄症的风险更高相关 (OR1.84). 到2025年ACC/AHA和2024年ESC指南的高血压类别与严重的冠状动脉样硬化有关.
结论:
- 青少年高血压水平与中年动脉样硬化的剂量依赖风险增加有关.
- 这种风险在严重的冠状动脉样硬化中尤为明显.
- 即使在当前ACC/AHA和ESC指南所定义的高血压范围内,也观察到过多的动脉样硬化风险.
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