Influencing Factors Of Cervical-femoral Pulse Wave Velocity In Patients With Essential Hypertension

Objective:Toexplore the influencing factors of carotid femoral pulse wave velocity and analyze the relationship between cf PWV and the ascending aorta diameter.Methods:A retrospective cross-section study was conducted of 654 patients aged over 18 years old who were admitted to the First Affiliated Hospital of Fujian Medical University from June 2017 to March 2019.General information were collected.Height,weight were measuredand blood lipid,uric acid,renal function and other biochemical indicatorswere detected.Blood pressure and heart rate were measured by Blood Pressure Monitor(OMRON HEM-7052)in sitting position.The cf PWV was measured with a fully automated arteriosclerosis measuring instrument(Complior France),the ascending aortic diameter(AAD)was determined with cardiac echocardiography.The total population was divided into 2 groups with cf PWV 10m/s as the cut-off point,normal cf PWV group(446 cases)and cf PWV elevated group(208 cases).According to the presence of hypertension and diabetes,patients were divided into 4 groups using the2 × 2 design standard: control group(180 cases),HT group(257 cases),DM group(70cases),HT combined with DM group(149 cases).Subgroupwasdividedbased on the age andgender.The differences and correlations of age,gender,BMI,blood pressure,biochemical parameters,AAD,cf PWV,RAS blockers,calcium antagonists and statins were compared among groups.Multiple linear regression and Logistic regression analysis were used to find out the influencing factors of cf PWV.ROC curve was drawn to calculate the cutoff value and sensitivity and specificity of the variable at the best diagnostic performance,to evaluate the predictive efficacy of AAD on atherosclerosis.Results:1.Compared with the normal cf PWV group,the age,AAD,SBP,HR,BMI,theproportions of hypertension,diabetes and the use of RAS blockers,calcium antagonists,and statinswere higher in the cf PWV elevated group,and LDL-C was lower(P <0.05).The age,AAD,cf PWV,BMI,SBP,DBP,creatinine,and uric acid in the HT group were higher than those in the control group and DM group(P<0.05).2.Single factor correlation analysis found that among all the subjects,AAD,age,BMI,SBP,DBP and HR were positively correlated with cf PWV(r = 0.22,0.45,0.10,0.52,0.09,0.12,P<0.05),total cholesterol and HDL-C wereinversely correlated with cf PWV(r =-0.10,-0.09,P<0.05).In the HT group,AAD,age and SBP were positively correlated with cf PWV(r = 0.22,0.47,0.44,P<0.05).3.Multiple linear regression analysis found that: age,SBP,DBP,HR and HDL-C were relevant factors of cf PWV in total population(P<0.05).In HT group(withoutdiabetes),age,AAD,SBP and TG were the relevant factor for cf PWV(P<0.05).Logistic stepwise regression analysis found that among all the subjects,age,HR,AAD,TG,hypertensionand diabetes were the relevantfactors of cf PWV(P<0.05)4.The ROC curve analysis of cf PWVasa diagonal line in the middle-aged and youngpatientswith hypertension(no diabetes,18 years old <age <65 years old)showed that the area under the curve was 0.673(95% CI: 0.584-0.761),and AAD> 3.11 cm,suggesting that there maybearisingtrend of cf PWV,with a sensitivity of 92.1% and a specificity of 41.1%,and the Youden Index0.332.Conclusion:1.Age,HR,AAD,TG,HTand DM are influencing factors of cf PWV.2.For essential hypertension patients(without diabetes),age,AAD,SBP and TG are related factors of cf PWV.If the AAD>3.11 cm,it has a certain predictive effect on atherosclerosis(sensitivity 92.1%,specificity 41.1%).