Association between pulse wave velocity and cerebral microbleeds: a systematic review and meta-analysis.

IF 4.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Carla Geovanna Lever-Megina, Iván Cavero-Redondo, Alicia Saz-Lara, Nerea Moreno-Herráiz, Elena Rescalvo-Fernández, Iris Otero-Luis
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Abstract

Cerebral microbleeds are associated with events that are among the highest mortality and disability events combined worldwide, as well as with hypertensive vasculopathy. The aim of the present study was to investigate the relationship between a marker of hypertensive vasculopathy, arterial stiffness assessed by pulse wave velocity, and cerebral microbleeds. A systematic review and meta-analysis was performed using PubMed, Scopus, and Web of Science, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Cochrane Collaboration Handbook statements. Data extraction, quality assessment and statistical analyses were performed following pre-established criteria. Twenty-one studies involving 18,436 participants were included. Higher levels of pulse wave velocity were associated with a higher presence of cerebral microbleeds p-OR = 1.26 (95% CI; 1.09-1.45), with considerable heterogeneity; even adjusting for potential confounding variables p-OR = 1.12 (95% CI, 1.05-1.20), with substantial heterogeneity. Only the percentage of women was related to p-OR in the adjusted model. Sensitivity analyses confirmed the robustness of our results. Adjusted models showed publication bias. Higher levels of arterial stiffness are associated with greater presence of cerebral microbleeds. This phenomenon may be caused by damage to the brain under higher blood flow loads, in turn due to age-induced reversal of the stiffness gradient between large and small vessels. As the world's population is undergoing demographic ageing, our results underline the importance of establishing pulse wave velocity as a cardiovascular marker for early screening and delaying the onset of the characteristic signs of both diseases.

脉搏波速度与脑微小出血之间的关系:系统回顾和荟萃分析。
脑微出血与全球死亡率和致残率最高的事件以及高血压血管病变有关。本研究旨在探讨高血压血管病变的标志物--脉搏波速度评估的动脉僵化与脑微小出血之间的关系。根据《流行病学观察性研究的荟萃分析》(MOOSE)和《Cochrane 协作手册》的声明,我们使用 PubMed、Scopus 和 Web of Science 进行了系统回顾和荟萃分析。数据提取、质量评估和统计分析均按照预先制定的标准进行。共纳入 21 项研究,涉及 18,436 名参与者。脉搏波速度越高,脑微小出血的发生率越高,p-OR = 1.26 (95% CI; 1.09-1.45),异质性很大;即使调整潜在的混杂变量,p-OR = 1.12 (95% CI, 1.05-1.20),异质性也很大。在调整后的模型中,只有女性比例与 p-OR 相关。敏感性分析证实了我们结果的稳健性。调整后的模型显示出发表偏倚。动脉僵化程度越高,脑微小出血越多。这种现象可能是由于在较高的血流负荷下大脑受到损伤,反过来又是由于年龄引起的大血管和小血管之间硬度梯度的逆转。随着世界人口老龄化的加剧,我们的研究结果凸显了将脉搏波速度作为心血管标志物的重要性,可用于早期筛查和延缓这两种疾病特征性症状的出现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hypertension Research
Hypertension Research 医学-外周血管病
CiteScore
7.40
自引率
16.70%
发文量
249
审稿时长
3-8 weeks
期刊介绍: Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.
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