Brachial-Ankle Pulse Wave Velocity And Ankle-Brachial Index Clinical Applications

Objective and Background The cardiovascular and cerebrovascular diseases have already become a major diease threatening people's health . And the arteriosclerosis plays an important role in the onset of these diseases.Hypertension,diabetes can help the development of arteriosclerosis. Because of the potential effects of assessing the degree of arterioscle rosis in cardiovascular and cerebrovascular diseases,as non-invasive indexes of assessing the degree of artery stiffness and artery obstruct, the Pulse Wave Velocity(PWV) and the Ankle-Brachial Index(ABI) are causing the attention day by day too. So we are trying to estimate the large artery stiffness of hypertension and diabetes by non-invasive measurement of PWV and ABI, discussing the roles of PWV and ABI, and discussing the relation of Pulse Wave Velocity with Ankle-Brachial Index through this study.Methods (1) 215 essential hypertension patients,78 type II diabetes patients,98 essential hypertension patients and type II diabetes patients and 136 normal adults admitted during the period of 2005 to 2007 are studied. They are separated into four groups .Every object of these groups is measured relevant parameters, such as brachial-ankle Pulse Wave Velocity,ABI,blood pressure,biochemical markers of blood ,etc. The datas are analyzed by analysis of variance(ANOVA),pearson correlation and multivariate stepwise regression to discuss the factors influencing brachial-ankle Pulse Wave Velocity.(2)Analyzing the correlation of baPWV with ABI of 527 objects in the first part,calculating the sick rate of lower limbs'peripheral artery diease, and analyzing the risk factors of ABI in type II diabetes patients.Result (1) There is no statistical significance in basic situations of patients among groups of hypertension,diabetes,hypertension and diabetes,health,such as age,sex,body mass index,etc. BaPWV is higher in the first three groups than that in the group of normal adults signifycantly (P<0.05), baPWV is significantly higher in the group of hypertension and diabetes than that in the groups of hypertension and diabetes(P<0.05). (2)In the group of normal adults,there is no relation of baPWV with triglyceride(TG),total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL) (P>0.05),but baPWV positively correlats with body mass index (r=0.417 P<0.01). There is statistical significance of baPWV among age groups (F=62.263 P<0.05), and there is also statistical significance of baPWV between the two genders in every age group(F=16.665 P<0.05). (3)There is no relation of baPWV with TG(r=0.016 P>0.05),TC(r=-0.005 P>0.05),HDL(r=-0.077 P>0.05),LDL(r=0.031 P>0.05)in hypertension patients. A multivariate stepwise regression demonstrates that the equation is baPWV (cm/s)= 145.537+13.743×age(year)+9.042×systolic blood pressure(mmHg)+6.035×pulse pressure(mmHg)+11.971×body mass index(kg/m2).(4) There is no relation of baPWV with fasting blood glucose and blood fat in diabetes patients(P>0.05),but there is positive relation of baPWV with course of diabetes,blood glycosylated hemoglobin(P<0.05),as the situation of age and blood pressure(P<0.01). (5)There is linear relation of baPWV with ABI by linear regression analyzing(P<0.05).Futhermore,there is relation of ABI with HDL,LDL,TC and HbA1C by the analysis of multivariate linear regression in type II diabetes patients(P<0.05).Conclusion Hypertension and diabetes increase the dangers of arteriosclerosis,and they togetherly accelerate the development of arteriosclerosis. Age,gender and body mass index are factors influencing large artery stiffness,which is increased by age.There is no relation between large artery stiffness and blood fat in the study of hypertension patients,but blood pressure is an important factor.Our study about Type II diabetes indicates that large artery stiffness is influenced by age,blood pressure,course of diabetes and blood glycosylated hemoglobin,but is independent of fasting blood glucose and blood fat.Novel blood fat and blood glycosylated hemoglobin are hazards of lower limbs'peripheral artery disease. The Pulse Wave Velocity is influenced by Ankle-Brachial Index.