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目的:探讨中老年人群心血管健康指标变化与动脉僵硬度的关系。方法:从2006年~2011年3次开滦集团职工体检者中,随机分层抽取增加了臂踝动脉脉搏波传导速度(ba PWV)测定的体检者4 190例,基线时平均年龄(49.78±9.74)岁。按照美国心脏协会(AHA)提出的7项心血管健康指标标准(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),每项指标分理想、一般、差3级,分别为2、1、0分。根据第1次、第3次体检的心血管健康评分变化(△CHS),将研究人群分为8组(依次为△CHS≤-4、-3、-2、-1、0、1、2、≥3分组,分别为241、368、611、855、911、647、354、203例)。采用线性回归、Logistic回归分析不同△CHS对ba PWV的影响。结果:随着△CHS由低向高转变(依次为△CHS≤-4、-3、-2、-1、0、1、2、≥3分组),baP WV值逐渐降低分别为(1 590.78±17.93、1 566.4±14.5、1 552.83±11.25、1 536.59±9.51、1 508.85±9.21、1 499.81±10.93、1 485.92±14.82、1 475.85±19.57)cm/s。多元线性回归分析显示:在校正多种混杂因素之后,△CHS每增加1分,baP WV减少15.58 cm/s(B=-15.58,P<0.001)。Logistic回归分析显示:在校正多种混杂因素之后,△CHS每增加1分,罹患动脉僵硬的风险降低14%(比值比=0.86,95%可信区间:0.83~0.90)。结论:△CHS与baP WV呈负相关。改善心血管健康指标可以降低中老年人群患动脉僵硬的风险。
Objective: To investigate the relationship between changes of cardiovascular health index and arterial stiffness in middle-aged and elderly people. Methods: From 1901 to 2011, 3 190 Kailuan Group workers were randomized to stratified extraction of 4 190 cases of increased physical examinations of brachial-ankle pulse wave velocity (ba PWV), mean age at baseline (49.78 ± 9.74) years old. According to the seven cardio-vascular criteria (no smoking, normal body mass index, active physical activity, healthy diet, normal cholesterol level, normal blood pressure level and normal fasting blood glucose level) proposed by the American Heart Association (AHA) , In general, poor 3, respectively, 2,1,0 points. The study population was divided into 8 groups (△ CHS ≦-4, -3, -2, -1, 0, 1, 2, respectively) according to the changes of cardiovascular health scores on the first and third physical examinations (△ CHS) , ≥3 group, respectively, 241,368,611,855,911,647,354,203 cases). Logistic regression was used to analyze the effect of different △ CHS on ba PWV by linear regression. Results: With the shift of △ CHS from low to high (△ CHS≤-4, -3, -2, -1,0,1,2, ≥3), the value of baP WV gradually decreased to (1 590.78 ± 17.93, 1 566.4 ± 14.5, 1 552.83 ± 11.25, 1 536.59 ± 9.51, 1 508.85 ± 9.21, 1 499.81 ± 10.93, 1 485.92 ± 14.82, 1 475.85 ± 19.57) cm / s. Multivariate linear regression analysis showed that the baP WV decreased 15.58 cm / s (B = -15.58, P <0.001) for each additional 1 point of △ CHS after correcting for various confounders. Logistic regression analysis showed a 14% reduction in the risk of developing arterial stiffness for every 1 point increase in △ CHS after adjusting for various confounders (odds ratio = 0.86, 95% confidence interval: 0.83-0.90). Conclusion: △ CHS and baP WV were negatively correlated. Improving cardiovascular fitness can reduce the risk of developing arterial stiffness in the middle-aged and elderly population.