cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2019.3.10235cardio-560Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONЦентральное аортальное давление: референсные и диагностические значенияCentral Aortic Pressure: Reference and Diagnostic ValuesКузнецовА. А.KuznetsovA. A.

Laboratory of Molecular Genetic Studies of Therapeutic Diseases

MD

kuznetsoviimed@gmail.comЦветковаЕ. Е.TsvetkovaE. E.

Laboratory of Molecular Genetic Studies of Therapeutic Diseases

ДенисоваД. В.DenisovaD. V.

Laboratory of Molecular Genetic Studies of Therapeutic Diseases

РагиноЮ. И.RaginoYu. I.

Laboratory of Molecular Genetic Studies of Therapeutic Diseases

ВоеводаМ. И.VoevodaM. I.

Laboratory of Molecular Genetic Studies of Therapeutic Diseases

Научно-исследовательский институт терапии и профилактической медицины – филиал ФГБНУ «Федеральный исследовательский центр Институт цитологии и генетики» СО РАНРоссияResearch Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of SciencesRussian Federation2019120420195931117Copyright © Kardiomag, 20192019KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/560

Цель исследования. Определение референсных значений, диагностических порогов и категории параметров центрального аортального давления (ЦАД) в общей популяции Новосибирска 25–44 лет. Материалы и методы. Обследованы 327 человек (155 мужчин, 172 женщины) в возрасте 25–44 лет из репрезентативной выборки из общей популяции Новосибирска. Аппланационную тонометрию радиальной артерии осуществили с использованием системы SphygmoCor. Референсные значения параметров ЦАД получали с помощью непараметрического метода согласно рекомендациям CLSI (95‑процентильный интервал с 2,5 % и 97,5 % отрезными точками и их 90 % доверительными интервалами). Диагностические пороги и категории ЦАД определяли как средние величины в зависимости от категорий плечевого артериального давления (АД) и на основе показателей риска, а также значений чувствительности и специфичности в отношении гипертрофии левого желудочка, подобных показателям риска и значениям чувствительности и специфичности пороговых уровней (категорий) плечевого АД. Результаты. Референсные границы параметров ЦАД составили 18–43 мм рт. ст. для пульсового давления; 5–24 мм рт. ст. для амплификации пульсового давления; – 8,8–40 % для индекса аугментации. Определили диагностические категории ЦАД: оптимальное – менее 110 / 80 мм рт. ст., нормальное – 110 / 80–114 / 84 мм рт. ст., высокое нормальное – 115 / 85–124 / 89 мм рт. ст., гипертензия – более 125 / 90 мм рт. ст. Заключение. Определены референсные значения, диагностические пороги и категории параметров ЦАД в общей популяции Новосибирска 25–44 лет. Целесообразно их дальнейшее изучение.

Objective. Practical application of central aortic pressure (CAP) parameters is limited by the absence of generally recognized reference and threshold diagnostic indices. The purpose of this work is to establish their values in the general population of Novosibirsk. Materials and Methods. A total of 327 people were examined: 155 men and 172 women aged 25–44 years from a representative sample from the general population of Novosibirsk. Applanation tonometry of the radial artery was performed by the SphygmoCor system. The reference values of CAP parameters were obtained by a nonparametric method according to the Clinical and Laboratory Standards Institute (CLSI) recommendations (95 % percentile interval with 2.5 % and 97.5 % cut-off points and their 90 % confidence intervals). Diagnostic thresholds and categories of CAP were determined as mean values depending on the categories of brachial arterial pressure (BP) and on the basis of risk estimates, as well as sensitivity and specificity values for left ventricular hypertrophy similar to risk and sensitivity and specificity values of threshold levels (categories) of brachial BP. Results. The reference values of the parameters of the CAP were: 18–43 mm Hg for pulse pressure; 5–24 mm Hg for the amplification of pulse pressure; – 8.8–40 % for the augmentation index. Diagnostic categories of CAP were determined to be: optimal – less than 110 / 80, normal – 110 / 80–114 / 84, high normal – 115 / 85–124 / 89, hypertension – more than 125 / 90 mm Hg. Conclusion. The reference values, diagnostic thresholds and categories of parameters of CAP in the general population of Novosibirsk aged 25–44 years have been determined. It is expedient to further study them.

центральное аортальное давлениереференсные значениядиагностические пороги и категорииобщая популяцияcentral aortic pressurereference valuesdiagnostic thresholds and categoriesgeneral populationReferencesSharman J.E., Laurent S. Central blood pressure in the management of hypertension: soon reaching the goal? J Hum Hypertens 2013;27(7):405–411. DOI: 10.1038/jhh.2013.23.Sharman J.E., Laurent S. Central blood pressure in the management of hypertension: soon reaching the goal? J Hum Hypertens 2013;27(7):405–411. DOI: 10.1038/jhh.2013.23.Herbert A., Cruickshank J.K., Laurent S., Boutouyrie P. Reference values for arterial measurements collaboration. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur Heart J 2014;35(44):3122–3133. DOI: 10.1093/eurheartj/ehu293.Herbert A., Cruickshank J.K., Laurent S., Boutouyrie P. Reference values for arterial measurements collaboration. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur Heart J 2014;35(44):3122–3133. DOI: 10.1093/eurheartj/ehu293.Cheng H.M., Chuang S.Y., Sung S.H. et al. Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks. J Am Coll Cardiol 2013;62(19):1780–1787. DOI: 10.1016/j.jacc.2013.06.029.Cheng H.M., Chuang S.Y., Sung S.H. et al. Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks. J Am Coll Cardiol 2013;62(19):1780–1787. DOI: 10.1016/j.jacc.2013.06.029.Hao G., Wang Z., Zhang L. et al. Thresholds of central systolic blood pressure in a normotensive chinese middle-aged population. Angiology 2016;67(2):174–179. DOI: 10.1177/0003319715584134.Hao G., Wang Z., Zhang L. et al. Thresholds of central systolic blood pressure in a normotensive chinese middle-aged population. Angiology 2016;67(2):174–179. DOI: 10.1177/0003319715584134.Chung J.W., Lee Y.S., Kin J.H. et al. Reference values for the augmentation index and pulse pressure in apparently healthy Korean subjects. Korean Circ J 2010;40:165–171. DOI: 10.4070/kcj.2010.40.4.165.Chung J.W., Lee Y.S., Kin J.H. et al. Reference values for the augmentation index and pulse pressure in apparently healthy Korean subjects. Korean Circ J 2010;40:165–171. DOI: 10.4070/kcj.2010.40.4.165.Li Y., Staessen J.A., Li L.H. et al. Reference values for the arterial pulse wave in Chinese. Am J Hypertens 2008;21:668–673. DOI: 10.1038/ajh.2008.151.Li Y., Staessen J.A., Li L.H. et al. Reference values for the arterial pulse wave in Chinese. Am J Hypertens 2008;21:668–673. DOI: 10.1038/ajh.2008.151.Shiburi C.P., Staessen J.A., Maseko M. et al. Reference values for SphygmoCorShiburi C.P., Staessen J.A., Maseko M. et al. Reference values for SphygmoCormeasurements in South Africans of African ancestry. Am J Hypertens 2006;19:40–46. DOI: 10.1016/j.amjhyper.2005.06.018.measurements in South Africans of African ancestry. Am J Hypertens 2006;19:40–46. DOI: 10.1016/j.amjhyper.2005.06.018.Wojciechowska W., Staessen J.A., Nawrot T. et al. Reference values in white Europeans for the arterial pulse wave recorded by means of the SphygmoCor device. Hypertens Res 2006;29:475–483. DOI: 10.1291/hypres.29.475.Wojciechowska W., Staessen J.A., Nawrot T. et al. Reference values in white Europeans for the arterial pulse wave recorded by means of the SphygmoCor device. Hypertens Res 2006;29:475–483. DOI: 10.1291/hypres.29.475.Woodiwiss A.J., Gavin R.N. Thresholds for central blood pressures and augmentation indices – are they needed and how far are we in the process of their definition? Current Hypertension Reviews 2012;8:91–99. DOI : 10.2174/157340212800840681.Woodiwiss A.J., Gavin R.N. Thresholds for central blood pressures and augmentation indices – are they needed and how far are we in the process of their definition? Current Hypertension Reviews 2012;8:91–99. DOI : 10.2174/157340212800840681.Staessen J.A., Gasowski J., Thijs L., Fagard R. Diagnostic thresholds for the clinical use of ambulatory pressure monitoring. Acta Physiol Pharmacol Bulg 1999;24:53–64.Staessen J.A., Gasowski J., Thijs L., Fagard R. Diagnostic thresholds for the clinical use of ambulatory pressure monitoring. Acta Physiol Pharmacol Bulg 1999;24:53–64.Kikuya M., Hansen T.W., Thijs L. et al. on behalf of the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) Investigators. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation 2007;115:2145–2152. DOI: 10.1161/CIRCULATIONAHA.106.662254.Kikuya M., Hansen T.W., Thijs L. et al. on behalf of the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) Investigators. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation 2007;115:2145–2152. DOI: 10.1161/CIRCULATIONAHA.106.662254.Staessen J.A., O’Brien E.T. Development of diagnostic thresholds for automated measurement of blood pressures in adults. Blood Press Monit 1999;4:127–136.Staessen J.A., O’Brien E.T. Development of diagnostic thresholds for automated measurement of blood pressures in adults. Blood Press Monit 1999;4:127–136.Staessen J.A., Thijs L. Development of diagnostic thresholds for automated self-measurement of blood pressure in adults. first international consensus conference on blood pressure self-measurement. Blood Press Monit 2000;5:101–109.Staessen J.A., Thijs L. Development of diagnostic thresholds for automated self-measurement of blood pressure in adults. first international consensus conference on blood pressure self-measurement. Blood Press Monit 2000;5:101–109.Wayne, P.A. Clinical Laboratory and Standards Institute. “How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline – Second Edition” CLSI document C28-A2, 2000.Wayne, P.A. Clinical Laboratory and Standards Institute. “How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline – Second Edition” CLSI document C28-A2, 2000.Horowitz G.L., Altaie S., Boyd J.C. et al. Clinical and Laboratory Standards Institute (CLSI). Defining, Establishing and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline – Third Edition CLSI document C28-A3, 2008.Horowitz G.L., Altaie S., Boyd J.C. et al. Clinical and Laboratory Standards Institute (CLSI). Defining, Establishing and Verifying Reference Intervals in the Clinical Laboratory; Approved Guideline – Third Edition CLSI document C28-A3, 2008.Avolio A.P., Van Bortel L.M., Boutouyrie P. et al. Role of pulse pressure amplification in arterial hypertension: experts’ opinion and review of the data. Hypertension 2009;54:375–383. DOI: 10.1161/HYPERTENSIONAHA.109.134379.Avolio A.P., Van Bortel L.M., Boutouyrie P. et al. Role of pulse pressure amplification in arterial hypertension: experts’ opinion and review of the data. Hypertension 2009;54:375–383. DOI: 10.1161/HYPERTENSIONAHA.109.134379.Gubner R.S., Ungerlieder H.E. Electrocardiographic criteria of left ventricular hypertrophy: factors determining the evolution of the electrocardiographic patterns in hypertrophy and bundle branch block. Arch Intern Med 1943;72:196–209. DOI: 10.1016/S0002-8703(43)90295-9.Gubner R.S., Ungerlieder H.E. Electrocardiographic criteria of left ventricular hypertrophy: factors determining the evolution of the electrocardiographic patterns in hypertrophy and bundle branch block. Arch Intern Med 1943;72:196–209. DOI: 10.1016/S0002-8703(43)90295-9.Sokolow M., Lyon T.P. The ventricular complex in left ventricular hypertrophy as obtained by unipolar and limb leads. Am Heart J 1949;37:161–186. DOI: 10.1016/0002-8703(49)90562-1.Sokolow M., Lyon T.P. The ventricular complex in left ventricular hypertrophy as obtained by unipolar and limb leads. Am Heart J 1949;37:161–186. DOI: 10.1016/0002-8703(49)90562-1.Hulsen H.T., Nijdam M.E., Bos W.J. et al. Spurious systolic hypertension in young adults; prevalence of high brachial systolic blood pressure and low central pressure and its determinants. J Hypertens 2006;24:1027–1032. DOI: 10.1097/01.hjh.0000226191.36558.9c.Hulsen H.T., Nijdam M.E., Bos W.J. et al. Spurious systolic hypertension in young adults; prevalence of high brachial systolic blood pressure and low central pressure and its determinants. J Hypertens 2006;24:1027–1032. DOI: 10.1097/01.hjh.0000226191.36558.9c.Mancia G., Fagard R., Narkiewicz K. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31(7):1281–1357. DOI: 10.1097/01.hjh.0000431740.32696.cc.Mancia G., Fagard R., Narkiewicz K. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31(7):1281–1357. DOI: 10.1097/01.hjh.0000431740.32696.cc.McEniery C.M., Yasmin, McDonnell B. et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension 2008;51(6):1476–1482. DOI: 10.1161/HYPERTENSIONAHA.107.105445.McEniery C.M., Yasmin, McDonnell B. et al. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension 2008;51(6):1476–1482. DOI: 10.1161/HYPERTENSIONAHA.107.105445.Takase H., Dohi Y., Kimura G. Distribution of central blood pressure values estimated by Omron HEM-9000AI in the Japanese general population. Hypertens Res 2013;36(1):50–57. DOI: 10.1038/hr.2012.122.Takase H., Dohi Y., Kimura G. Distribution of central blood pressure values estimated by Omron HEM-9000AI in the Japanese general population. Hypertens Res 2013;36(1):50–57. DOI: 10.1038/hr.2012.122.Niiranen T.J., Asayama K., Thijs L. et al. Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome. Hypertension 2013;61(1):27–34. DOI: 10.1161/HYPERTENSIONAHA.111.00100.Niiranen T.J., Asayama K., Thijs L. et al. Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome. Hypertension 2013;61(1):27–34. DOI: 10.1161/HYPERTENSIONAHA.111.00100.McEniery C. M., Yasmin, Hall I. R., Qasem A. et al. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity. The Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005;46:1753–1760.McEniery C. M., Yasmin, Hall I. R., Qasem A. et al. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity. The Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005;46:1753–1760.Mitchell G. F., Wang N., Palmisano J. N. et al. Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham heart study. Circulation 2010;122:1379–1386. DOI: 10.1161/CIRCULATIONAHA.109.914507.Mitchell G. F., Wang N., Palmisano J. N. et al. Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham heart study. Circulation 2010;122:1379–1386. DOI: 10.1161/CIRCULATIONAHA.109.914507.Townsend R.R., Black H.R., Chirinos J.A. et al. Clinical use of pulse wave analysis: proceedings from a symposium sponsored by North American Artery. J Clin Hypertens (Greenwich) 2015;17(7):503–513. DOI: 10.1111/jch.12574.Townsend R.R., Black H.R., Chirinos J.A. et al. Clinical use of pulse wave analysis: proceedings from a symposium sponsored by North American Artery. J Clin Hypertens (Greenwich) 2015;17(7):503–513. DOI: 10.1111/jch.12574.

The authors declare that there are no conflicts of interest present.