rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2016-12-2-118-128rpcardio-1223Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯCORRELATIONS OF DIFFERENT STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF ARTERIAL WALL WITH TRADITIONAL CARDIOVASCULAR RISK FACTORS IN HEALTHY PEOPLE OF DIFFERENT AGE. PART 1ВЗАИМОСВЯЗЬ МЕЖДУ РАЗЛИЧНЫМИ СТРУКТУРНО-ФУНКЦИОНАЛЬНЫМИ ХАРАКТЕРИСТИКАМИ СОСТОЯНИЯ АРТЕРИАЛЬНОЙ СТЕНКИ И ТРАДИЦИОННЫМИ ФАКТОРАМИ КАРДИОВАСКУЛЯРНОГО РИСКА У ЗДОРОВЫХ ЛЮДЕЙ РАЗНОГО ВОЗРАСТА. ЧАСТЬ 1СтражескоИ. Д.StrazheskoI. D.

Стражеско Ирина Дмитриевна – кандидат медицинских наук,  ведущий научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Irina D. Strazhesko – MD, PhD, Leading Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, State Research Center for Preventive Medicine (SRC PM) 

istrazhesko@gmail.comТкачеваО. Н.TkachevaO. N.

Ткачева Ольга Николаевна – доктор медицинских наук, профессор, руководитель того отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ, директор РГНКЦ РНИМУ имени Н.И. Пирогова

Olga N. Tkacheva – MD, PhD, Professor, Head of the Department of Investigation of Ageing and Age-associated Diseases Prevention; Director of the Russian Gerontology Research Center, Russian National Research Medical University named after Y.I. Pirogov

istrazhesko@gmail.comАкашеваД. У.AkashevaD. U.

Акашева Дарига Уайдинична – кандидат медицинских наук,  ведущий научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

 Dariga U. Akasheva – MD, PhD, Leading Researcher of the of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comДудинскаяЕ. В.DudinskayaE. V.

Дудинская Екатерина Наильевна – кандидат медицинских наук,  ведущий научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Ekaterina N. Dudinskaya – MD, PhD, Leading Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM 

istrazhesko@gmail.comАгальцовМ. В.AgaltsovM. V.

Агальцов Михаил Викторович – кандидат медицинских наук,  старший научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ 

Michail V. Agaltsov – MD, PhD, Senior Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comКругликоваА. С.KruglikovaA. S.

Кругликова Анна Сергеевна – младший научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Anna S. Kruglikova – MD, Junior Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comБраиловаН. В.BrailovaN. V.

Браилова Наталья Васильевна – младший научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Natalya V. Brailova – MD, Junior Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comПыхтинаВ. С.PykhtinaV. S.

Пыхтина Валентина Сергеевна – младший научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ 

Valentina S. Pykhtina – MD, Junior Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comПлоховаЕ. В.PlokhovaE. V.

Плохова Екатерина Владимировна – кандидат медицинских наук,  научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Ekaterina V. Plokhova – MD, PhD, Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comШарашкинаН. В.SharashkinaN. V.

Шарашкина Наталья Викторовна – кандидат медицинских наук,  старший научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний ГНИЦ ПМ

Natalya V. Sharashkina – MD, PhD, Senior Researcher of the Department of Investigation of Ageing and Age-associated Diseases Prevention, SRC PM

istrazhesko@gmail.comИсайкинаО. Ю.IsaykinaO. Yu.

Исайкина Олеся Юрьевна – кандидат медицинских наук,  старший научный сотрудник отдела первичной профилактики хронических неинфекционных заболеваний в системе здравоохранения ГНИЦ ПМ

Olesya Yu. Isaykina – MD, PhD, Senior Researcher of the Department of Primary Prevention of Chronic Non-infectious Diseases, SRC PM 

istrazhesko@gmail.comВыгодинВ. А.VygodinV. A.

Выгодин Владимир Анатольевич – старший научный сотрудник лаборатории биостатистики ГНИЦ ПМ

Vladimir A. Vygodin – Senior Researcher of the Laboratory of Biostatistics, SRC PM

istrazhesko@gmail.comБойцовС. А.BoytsovS. A.

Бойцов Сергей Анатольевич – доктор медицинских наук, профессор, руководитель отдела кардиологии и молекулярной генетики, директор ГНИЦ ПМ

Sergey A. Boytsov – MD, PhD, Professor, Head of the Department of Cardiology and Molecular Genetics, SRC PM, Director of the SRC PM

istrazhesko@gmail.comГосударственный научно-исследовательский центр профилактической медицины, Москва; Российский геронтологический научно-клинический центр, Российский Национальный исследовательский медицинский университет имени Н. И. Пирогова, МоскваРоссияState Research Centre for Preventive Medicine, MoscowRussian FederationГосударственный научно-исследовательский центр профилактической медицины, МоскваРоссияState Research Centre for Preventive Medicine, Moscow; Russian Gerontology Research Center, Russian National Research Medical University named after Y.I. Pirogov, MoscowRussian FederationГосударственный научно-исследовательский центр профилактической медицины, МоскваРоссияState Research Centre for Preventive Medicine, MoscowRussian Federation201604052016122118128Copyright © Strazhesko I.D., Tkacheva O.N., Akasheva D.U., Dudinskaya E.V., Agaltsov M.V., Kruglikova A.S., Brailova N.V., Pykhtina V.S., Plokhova E.V., Sharashkina N.V., Isaykina O.Y., Vygodin V.A., Boytsov S.A., 20162016Стражеско И.Д., Ткачева О.Н., Акашева Д.У., Дудинская Е.В., Агальцов М.В., Кругликова А.С., Браилова Н.В., Пыхтина В.С., Плохова Е.В., Шарашкина Н.В., Исайкина О.Ю., Выгодин В.А., Бойцов С.А.Strazhesko I.D., Tkacheva O.N., Akasheva D.U., Dudinskaya E.V., Agaltsov M.V., Kruglikova A.S., Brailova N.V., Pykhtina V.S., Plokhova E.V., Sharashkina N.V., Isaykina O.Y., Vygodin V.A., Boytsov S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1223

Arterial wall status is determined by several characteristics, the main of them are as follows: pulse wave velocity (PWV), carotid arteries intima-media thickness (IMT), the presence of atherosclerotic plaques, endothelium-dependent vasodilation (EDVD). When these parameters change, the risk for cardiovascular disease (CVD) grows. The nature of relationship between these indices in people without CVD clinical signs is understudied, especially in those of older age.Aim. To estimate correlations between different parameters of arterial wall in patients of different age without CVD.Material and methods. A total of 303 people aged 25-91 years without any manifestations of CVD or other chronic diseases and without regular medical treatment were examined. PWV estimation, carotid ultrasound with IMT measurement and atherosclerotic plaques amount calculation and EDVD estimation using reactive hyperemia test were performed. Results. Patients without CVD clinical signs rather often reveal arterial wall lesions already in the younger age group (mean age 40.9±8.7): reduced EDVD – in 26% of the cases, the presence of atherosclerotic plaques – in 22%, increased PWV – in 15%, increased IMT – in 8%. The prevalence of arterial wall alterations in the older age group (mean age 61.19±8.5) increase many-fold. All arterial wall parameters correlate with age. The stronger correlation was revealed between IMT and the amount of atherosclerotic plaques: r=0.46 (р<0.001) in the younger group and r=0.47 (р<0.001) in the older one. We didn’t find any relationship between PWV and EDVD in the younger group and between PWV and the amount of atherosclerotic plaques in the older one. Thickened carotid intima-media increases the risk of arterial stiffness by 2.3 times.Conclusion. Estimation of the state of arterial wall in people of young age without CVD allows detecting individuals who require active CVD prevention. Increased stiffness of arterial wall and the development of subclinical atherosclerosis represent different phenotypes of alterations.

Состояние артериальной стенки определяется несколькими характеристиками, среди которых важнейшие: скорость распространения пульсовой волны (СРПВ), толщина комплекса интима-медиа сонных артерий (ТКИМ), наличие атеросклеротических бляшек (АСБ), эндотелий-зависимая вазодилятация (ЭЗВД). При их изменении возрастает риск сердечно-сосудистых заболеваний (ССЗ). Характер взаимосвязи этих показателей у людей без клинических проявлений ССЗ изучены недостаточно, особенно у людей старшего возраста.Цель. Изучить особенности взаимосвязи между отдельными параметрами артериальной стенки у лиц разного возраста, не страдающих ССЗ.Материал и методы. Обследовано 303 человека в возрасте от 25 до 91 года без признаков ССЗ и других хронических заболеваний, не получавших регулярную медикаментозную терапию. Проводилось измерение СРПВ, ультразвуковое исследование каротидных артерий для определения ТКИМ и количества АСБ. Определение ЭЗВД проводили с использованием пробы с реактивной гиперемией.Результаты. У лиц без клинических проявлений ССЗ изменения артериальной стенки встречаются достаточно часто уже в младшей группе (средний возраст 40,9±8,7 лет): сниженная ЭЗВД – у 26%, наличие АСБ – у 22%, повышенная СРПВ – у 15%, повышенная ТКИМ – у 8%. В старшей группе (средний возраст 61,1±8,5 лет) распространенность изменений стенки артерии возрастает кратно. Все параметры состояния артериальной стенки коррелируют с возрастом. Наиболее сильная взаимосвязь наблюдается между ТКИМ и количеством АСБ: r=0,46 (р<0,001) в младшей группе и r=0,47 (р<0,001) в старшей группе. Не прослеживается взаимосвязь между СРПВ и ЭЗВД в младшей группе, между СРПВ и АСБ в старшей. Увеличенная ТКИМ повышает вероятность наличия жестких артерий в 2,3 раза.Заключение. Изучение состояния артериальной стенки уже в младшей группе лиц без ССЗ позволяет выявить группу людей, нуждающихся в проведении активной программы профилактики ССЗ. Повышение жесткости артериальной стенки и развитие субклинического атеросклероза представляют различные фенотипы изменений.

артериальная стенкаскорость распространения пульсовой волнытолщина комплекса интима-медиаатеросклеротические бляшкиэндотелий-зависимая вазодилятацияarterial wallpulse wave velocityintima-media thicknessatherosclerotic plaquesendothelium-dependent vasodilationReferencesFuster V., Kelly B.B., Vedanthan R. Global cardiovascular health: urgent need for an intersectoral approach. J Am Coll Cardiol 2011; 58(12):1208-10.Fuster V., Kelly B.B., Vedanthan R. Global cardiovascular health: urgent need for an intersectoral approach. J Am Coll Cardiol 2011; 58(12):1208-10.Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol 2002;11:101-7.Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol 2002;11:101-7.Hunink M.G., Goldman L., Tosteson A.N. et al. The recent decline in mortality from coronary heart disease, 1980-1990: the effect of secular trends in risk factors and treatment. JAMA 1997;277:535-42.Hunink M.G., Goldman L., Tosteson A.N. et al. The recent decline in mortality from coronary heart disease, 1980-1990: the effect of secular trends in risk factors and treatment. JAMA 1997;277:535-42.Vlachopoulos C., Aznaouridis K., Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55(13):1318-27.Vlachopoulos C., Aznaouridis K., Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55(13):1318-27.Tziomalos K., Athyros V.G., Karagiannis A. et al. The role of ankle brachial index and carotid intima-media thickness in vascular risk stratification. Curr Opin Cardiol 2010; 25(4):394-8.Tziomalos K., Athyros V.G., Karagiannis A. et al. The role of ankle brachial index and carotid intima-media thickness in vascular risk stratification. Curr Opin Cardiol 2010; 25(4):394-8.Green D.J., Jones H., Thijssen D. et al. Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter? Hypertension 2011; 57(3):363-9.Green D.J., Jones H., Thijssen D. et al. Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter? Hypertension 2011; 57(3):363-9.Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III). Circulation 2002; 106: 3143.Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III). Circulation 2002; 106: 3143.Van Bortel L.M., Laurent S., Boutouyrie P., et al. Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotidfemoral pulse wave velocity. J Hypertens 2012; 30(3):445-8.Van Bortel L.M., Laurent S., Boutouyrie P., et al. Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotidfemoral pulse wave velocity. J Hypertens 2012; 30(3):445-8.Touboul P.J., Hennerici M.G., Meairs S. et al. Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis 2007;23(1):75-80.Touboul P.J., Hennerici M.G., Meairs S. et al. Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis 2007;23(1):75-80.Perk J., De Backer G., Gohlke H. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts. European Heart Journal 2012; 33: 1635-701.Perk J., De Backer G., Gohlke H. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts. European Heart Journal 2012; 33: 1635-701.Corretti M.C., Anderson T.J., Benjamin E.J. et al. Guidelines for the ultrasound assessment of endothelialdependent flowmediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002; 39(2):257-65.Corretti M.C., Anderson T.J., Benjamin E.J. et al. Guidelines for the ultrasound assessment of endothelialdependent flowmediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol 2002; 39(2):257-65.Kuller L., Borhani N., Furberg C. et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 1994;139(12):1164-79.Kuller L., Borhani N., Furberg C. et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 1994;139(12):1164-79.Cunha P.G., Cotter J., Oliveira P. et al. An epidemiological study determining blood pressure in a Portuguese cohort: the Guimarães/Vizelastudy. J Hum Hypertens 2015;29(3):190-7.Cunha P.G., Cotter J., Oliveira P. et al. An epidemiological study determining blood pressure in a Portuguese cohort: the Guimarães/Vizelastudy. J Hum Hypertens 2015;29(3):190-7.Ter Avest E., Stalenhoef A.F., de Graaf J. What is the role of non-invasive measurements of athero sclerosis in individual cardiovascular risk prediction? Clin Sci (London) 2007;112:507-16.Ter Avest E., Stalenhoef A.F., de Graaf J. What is the role of non-invasive measurements of athero sclerosis in individual cardiovascular risk prediction? Clin Sci (London) 2007;112:507-16.Neunteufl T., Katzenschlager R., Hassan A. et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997;129:111-8.Neunteufl T., Katzenschlager R., Hassan A. et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997;129:111-8.Chan S.Y., Mancini G.B., Kuramoto L. et al. The prognostic importance of endothelial dysfunction and carotid atheroma burden in patients with coronary artery disease. J Am Coll Cardiol 2003;42:1037-43.Chan S.Y., Mancini G.B., Kuramoto L. et al. The prognostic importance of endothelial dysfunction and carotid atheroma burden in patients with coronary artery disease. J Am Coll Cardiol 2003;42:1037-43.Niiranen T., Jula A., Kantola I. et al. Home-measured blood pressure is more strongly associated with atherosclerosis than clinic blood pressure: the Finn-HOME Study. J Hypertens 2007; 25:1225-31.Niiranen T., Jula A., Kantola I. et al. Home-measured blood pressure is more strongly associated with atherosclerosis than clinic blood pressure: the Finn-HOME Study. J Hypertens 2007; 25:1225-31.Burke G.L., Evans G.W., Riley W.A. et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 1995;26:386-91.Burke G.L., Evans G.W., Riley W.A. et al. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 1995;26:386-91.O'Leary D.H., Polak J.F., Kronmal R.A. et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340:14-22.O'Leary D.H., Polak J.F., Kronmal R.A. et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999; 340:14-22.Kobayashi K., Akishita M., Yu W. et al. Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 2004;173:13-8.Kobayashi K., Akishita M., Yu W. et al. Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 2004;173:13-8.Soltesz P., Der H., Kerekes G. et al. A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases. Clin Rheumatol 2009; 28:655-62.Soltesz P., Der H., Kerekes G. et al. A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases. Clin Rheumatol 2009; 28:655-62.Nigam A.; Mitchell G.F.; Lambert J. et al. Relation between conduit vessel stiffness (assessed by tonometry) and endothelial function (assessed by flowmediated dilatation) in patients with and without coronary heart disease. Am J Cardiol 2003;92:395-9.Nigam A.; Mitchell G.F.; Lambert J. et al. Relation between conduit vessel stiffness (assessed by tonometry) and endothelial function (assessed by flowmediated dilatation) in patients with and without coronary heart disease. Am J Cardiol 2003;92:395-9.Liang Y.L., Teede H., Kotsopoulos D. et al. Non-invasive measurements of arterial structure and function: repeatability, interrelationships and trial sample size. Clin Sci (Lond) 1998;95:669-79.Liang Y.L., Teede H., Kotsopoulos D. et al. Non-invasive measurements of arterial structure and function: repeatability, interrelationships and trial sample size. Clin Sci (Lond) 1998;95:669-79.Koivistoinen T., Virtanen M., Hutri-Kahonen N. et al. Arterial pulse wave velocity in relation to carotid intima-media thickness, brachial flow-mediated dilation and carotid artery distensibility: The Cardiovascular Risk in Young Finns Study and the Health 2000 Survey. Atherosclerosis 2012;220: 38793.Koivistoinen T., Virtanen M., Hutri-Kahonen N. et al. Arterial pulse wave velocity in relation to carotid intima-media thickness, brachial flow-mediated dilation and carotid artery distensibility: The Cardiovascular Risk in Young Finns Study and the Health 2000 Survey. Atherosclerosis 2012;220: 38793.van Popele N.M., Grobbee D.E., Bots M.L. et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001;32:454-60.van Popele N.M., Grobbee D.E., Bots M.L. et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001;32:454-60.Zureik M., Temmar M., Adamopoulos C. et al. Carotid plaques, but not common carotid intima-media thickness, are independently associated with aortic stiffness. J Hypertens 2002;20:85-93.Zureik M., Temmar M., Adamopoulos C. et al. Carotid plaques, but not common carotid intima-media thickness, are independently associated with aortic stiffness. J Hypertens 2002;20:85-93.

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