中心动脉压、动脉硬化与脑卒中的研究进展

Advances in research on central arterial pressure, arterial stiffness, and stroke

摘要:

脑卒中是常见的心脑血管疾病,具有高发病率、高致残率和高死亡率的特点,其发生发展涉及多种危险因素和复杂机制。血压异常升高是脑卒中最重要的可控危险因素之一,而中心动脉压和动脉硬化可从血管功能与结构层面反映大动脉状态,可能为脑卒中风险评估提供额外信息。此外,以胰岛素抵抗和血脂紊乱为代表的代谢异常可加重血管损伤,进一步增加脑卒中风险。本文采用叙述性文献综述方法,系统总结中心动脉压与动脉硬化在脑卒中发生发展中的相关证据,并从流行病学、人群队列、病理生理机制及心血管代谢等方面探讨其潜在作用,以期为脑卒中的一级预防和个体化精准管理提供理论依据。

Abstract:

Stroke is a common cardiovascular and cerebrovascular disease characterized by high incidence, high disability, and high mortality rates, with multiple risk factors and complex underlying mechanisms. Elevated blood pressure is one of the most important modifiable risk factors for stroke, while central arterial pressure and arterial stiffness reflect large-artery function and structure and may provide additional information for stroke risk assessment. In addition, metabolic abnormalities, particularly insulin resistance and dyslipidemia, may aggravate vascular injury and further increase the risk of stroke. This narrative review summarizes current evidence on the roles of central arterial pressure and arterial stiffness in the development and progression of stroke and discusses their potential implications from the perspectives of epidemiology, population-based cohort studies, pathophysiological mechanisms, and cardiometabolism, with the aim of providing a theoretical basis for optimizing primary prevention and individualized precision management of stroke.