临床实践中,大多数患者我会测定PWV和脉搏波分析(PWA)。需要特别指出的是,所有初次诊断的高血压患者我都会评价血管功能,同时每年进行随访,采用PWV和PWA来计算心血管风险。
International Circulation: There’re several methods to assess the arterial stiffness, such as PWV, ABI, pulse pressure index. How do you appraise these methods?
Park:In practise, in most of patients I measure PWV and pulse wave analysis (PWA). Particularly I do estimate vascular function in all patients of naive hypertensive patients and follow-up annually to calculate cardiovacualr risk using PWV and PWA. ABI is different. Pulse feeling by hands on both radial and post tibial artery is important, and so only when there is difference between right and left or upper and lower, I apply ABI measurement. I don’t use ABI as a tool for CV risk estimation.
International Circulation: Is arterial stiffness an independent risk factor or is it more associated with other traditional risk factors?
Park:It is quite well know most parameters of arterial stiffness are independent from traditional CV risk factors, such as blood pressure, glucose, lipid, smoking and more. Even though these are closely associated with traditional CV risk factors, there surely exits independency.
《国际循环》:有几个方法可被用于评价动脉僵硬度,包括脉搏波传导速度(PWV)、踝臂指数(ABI)和脉压指数。你如何评价这些方法?
Park教授:临床实践中,大多数患者我会测定PWV和脉搏波分析(PWA)。需要特别指出的是,所有初次诊断的高血压患者我都会评价血管功能,同时每年进行随访,采用PWV和PWA来计算心血管风险。ABI与PWV有所不同。用手来触摸桡动脉和胫后动脉的脉搏是重要的,只有当左侧和右侧或者上肢和下肢的脉搏有差别时,我才测定ABI。ABI不是评估心血管风险的工具。
《国际循环》:动脉僵硬度是独立的心血管危险因素还是与其他传统的心血管危险因素关系更大?
Park教授:众所周知,大多数动脉僵硬度指标独立于传统的心血管危险因素(例如血压、血糖、血脂和吸烟)。尽管动脉僵硬度指标与传统心血管危险因素紧密相关,但是这些指标确实是独立的心血管危险因素。