Objective: To investigate the impact of change of ideal cardiovascular behavior and related factors on healthy vascular aging(HVA). Methods: This study was a multi-center cross-sectional survey. Six thousand three hundred and sixteen participants who underwent at least 2 healthy examinations from 2006 to 2015 at 11 hospitals, including Kailuan Hospital and so on, and examined brachial-ankle pulse wave velocity (baPWV) during 2010 and 2016, with available information about cardiovascular behavior and factors were included. The cardiovascular health score (CHS) was calculated. Basic CHS was collected from the first examination. The second CHS derived from the healthy examination in the same year of baPWV examination. Change of cardiovascular health score (ΔCHS) was calculated. Participants were defined into 5 groups according to ΔCHS, namely ΔCHS≤-2 (n=2 166), ΔCHS=-1 (n=1 284), ΔCHS=0 (n=1 187), ΔCHS=1 (n=860), and ΔCHS≥2 (n=819). Participants' characteristics, value of baPWV and proportion of HVA were compared among different groups. Multiple logistic regression analysis was used to investigate the association between ΔCHS and HVA. The ΔCHS was recalculated and included in multiple logistic regression analysis model again after each component of the cardiovascular health metrics was removed separately in order to investigate effects of removal factors on HVA by observing changes in effect values. Results: The percentage of the participants with HVA in the group of ΔCHS≤-2, ΔCHS=-1, ΔCHS=0, ΔCHS=1 and ΔCHS≥2 were 23.3%(505/2 166), 27.8%(357/1 284), 28.7%(341/1 187),31.9%(274/860) and 33.9%(278/819), respectively. After adjustment for age, sex, income, education, alcohol consumption and the basic CHS, a significant positive association between ΔCHS and proportion of participants with HVA was observed (OR=1.50, 95%CI 1.44-1.56). Multiple regression analysis after removing each single cardiovascular behavior or factor showed that the OR value decreased as follow systolic blood pressure (OR=1.04, 95%CI 1.00-1.09), fasting blood glucose (OR=1.14, 95%CI 1.09-1.18), physical exercise (OR=1.16, 95%CI 1.11-1.21), salt intake (OR=1.17, 95%CI 1.12-1.22), body mass index (OR=1.18, 95%CI 1.13-1.23), smoking(OR=1.18, 95%CI 1.13-1.23) and total cholesterol (OR=1.20, 95%CI 1.16-1.24). Conclusion: The improvement of every ideal cardiovascular behavior and factor is associated with the increase of the proportion of HVA population.
目的： 探讨理想心血管健康行为与因素变化对健康老龄血管（HVA）的影响。 方法： 该研究为多中心横断面调查，入选人群为在开滦总医院、开滦林西医院、开滦赵各庄医院等11家医院进行健康体检的开滦集团在职及离退休职工。以2006—2015年至少参加2次健康体检，且心血管健康行为与因素资料完整，并于2010—2016年底接受过臂踝脉搏波传导速度（baPWV）检测者6 316人为研究对象。计算入选者的心血管健康评分（CHS），其中基线CHS取自首次体检资料，第2次CHS取自与baPWV检测在同一年度的体检资料，计算2次CHS的差值（ΔCHS）。按ΔCHS将入选者分为5组，即ΔCHS≤-2组（n=2 166）、ΔCHS=-1组（n=1 284）、ΔCHS=0组（n=1 187）、ΔCHS=1组（n=860）和ΔCHS≥2组（n=819）。比较各组人群的一般资料、baPWV及HVA检出率，并采用多因素logistic逐步回归分析ΔCHS与HVA的关系，然后分别移除1个健康行为或因素后重新计算ΔCHS，并再次纳入多因素logistic逐步回归模型，探讨移除因素对HVA的影响。 结果： ΔCHS≤-2、ΔCHS=-1、ΔCHS=0、ΔCHS=1和ΔCHS≥2组人群的HVA检出率分别为23.3%（505/2 166）、27.8%（357/1 284）、28.7%（341/1 187）、31.9%（274/860）、33.9%（278/819）。校正了年龄、性别、收入、饮酒、教育、基线CHS后，多因素logistic回归分析结果显示ΔCHS与HVA呈正相关（OR=1.50，95%CI 1.44~1.56）。在总的理想心血管健康行为与因素中，分别移除1个行为或因素后，多因素logistic回归分析结果显示，OR值下降幅度从大到小的行为或因素依次为收缩压（OR=1.04，95%CI 1.00~1.09）、空腹血糖（OR=1.14，95%CI 1.09~1.18）、体育锻炼（OR=1.16，95%CI 1.11~1.21）、食盐量（OR=1.17，95%CI 1.12~1.22）、体重指数（OR=1.18，95%CI 1.13~1.23）、吸烟（OR=1.18，95%CI 1.13~1.23）和总胆固醇（OR=1.20，95%CI 1.16~1.24）。 结论： 改善理想心血管健康行为与因素有助于增加HVA人群的比例。.
Keywords: Arteriosclerosis; Healthy vascular aging; Ideal cardiovascular behavior and factors.