Abstract: Background  With the development of social economy and the aggravation of aging，the prevalence of hypertension is increasing.Monitoring the elasticity and sclerosis of arteries and giving corresponding interventions in hypertensive patients，can prevent，and delay the progression of cardiovascular disease.Objective  To explore the prevalence of vascular lesions and its influencing factors in patients with hypertension in the community，providing a theoretical basis for early detection and prevention of arteriosclerosis.Methods  The enrolled 411 hypertensive patients were sampled from individuals undergoing physical examination in the outpatient clinic of Shunde Lecong Community Health Center between May and July 2018，including 45 with ideal blood pressure control（group A），142 with good blood pressure control（group B） and 224 with poor blood pressure control（group C）．The brachial-ankle pulse wave velocity（baPWV），carotid-femoral pulse wave velocity（cfPWV） as well as ankle-brachial index（ABI） were analyzed comparatively.Influencing factors of the detected vascular lesion were analyzed by using multivariate Logistic regression.Results  Mean baPWV and cfPWV differed significantly between the groups（P<0.05），while mean ABI did not（P>0.05）．There was a significantly positive correlation between blood pressure control and baPWV（rs=0.406，P<0.001），as well as cfPWV（rs=0.381，P<0.001）.Multivariate Logistic regression model indicated age〔OR=1.102，95%CI（1.069，1.136）〕，serum ALT〔OR=0.966，95%CI（0.934，0.999）〕 and serum total bilirubin〔OR=1.065，95%CI（1.023，1.110）〕 were independent influencing factors of baPWV；and age〔OR=1.106，95%CI（1.071，1.141）〕，serum ALT〔OR=0.952，95%CI（0.917，0.988）〕and serum AST〔OR=1.052，95%CI（1.007，1.100）〕were independent influencing factors of cfPWV.Conclusion  Blood pressure control is associated with vascular sclerosis in hypertensive patients.So community-based hypertension management should be strengthened to effectively prevent or delay the occurrence and development of cardiovascular diseases.

Key words: Hypertension, Vascular disease, Brachial-ankle pulse wave velocity, Carotid-femoral pulse wave velocity, Ankle-brachial index, Root cause analysis

摘要： 背景  随着社会经济的发展和人口老龄化的加剧，我国人群高血压的患病率逐年升高。对高血压患者的动脉血管弹性度、硬化度进行监测与干预，可以延缓心血管事件进程、预防心血管疾病发生。目的  探讨社区高血压患者的血管病变情况及其影响因素，为动脉硬化的早期发现和预防提供理论依据。方法  选取2018年5—7月于佛山市顺德区乐从社区卫生服务中心门诊体检的高血压患者411例，按照血压水平分成3组：血压控制理想组（A组）45例、血压控制良好组（B组）142例、血压控制不良组（C组）224例。评估各组血管病变情况，包括肱踝脉搏波传导速度（baPWV）、颈股脉搏波传导速度（cfPWV）及踝臂指数（ABI）。各组血管病变的影响因素采用多因素Logistic回归分析。结果  A、B、C 3组的baPWV、cfPWV比较，差异有统计学意义（P<0.05），而ABI在3组间差异无统计学意义（P>0.05）。血压控制情况与baPWV（rs=0.406，P<0.001）和cfPWV（rs=0.381，P<0.001）呈正相关。多因素Logistic回归分析结果显示：年龄〔OR=1.102，95%CI（1.069，1.136）〕、血清丙氨酸氨基转移酶〔OR=0.966，95%CI（0.934，0.999）〕及总胆红素〔OR=1.065，95%CI（1.023，1.110）〕水平为baPWV的独立影响因素；年龄〔OR=1.106，95%CI（1.071，1.141）〕、血清丙氨酸氨基转移酶〔OR=0.952，95%CI（0.917，0.988）〕及天冬氨酸氨基转移酶〔OR=1.052，95%CI（1.007，1.100）〕水平为cfPWV的独立影响因素。结论  社区高血压患者的血压控制情况与血管硬化水平相关，社区卫生服务机构应加强对高血压人群的血压管理，从而有效地预防和延缓心脑血管疾病的发生和发展。

关键词: 高血压, 血管病变, 肱踝脉搏波传导速度, 颈股脉搏波传导速度, 踝臂指数, 影响因素分析