Hypertension (HTN) is an important risk factor for cardiovascular disease (CVD) but the association between HTN and CVD cannot be explained by average blood pressure (BP) alone. BP variability (BPV) is another important factor, along with the effects of HTN on the vasculature. The concept of systemic hemodynamic atherothrombotic syndrome (SHATS) has been proposed, describing an age-related and synergistic vicious cycle of hemodynamic stress and vascular disease. The importance of SHATS is based on the assumption that the assessment of BPV and arterial disease is likely to provide an effective opportunity to intervene early to reduce progression to HTN in younger patients or to CVD events and organ damage in older patients. In addition to providing an overview of current evidence for the mechanisms and clinical data related to SHATS, this article proposes a new SHATS score for use to diagnose and assess the severity of SHATS. The score includes two components - a BP score and a vascular score - which are multiplied to generate the SHATS score. This reflects the synergistic, rather than additive, effects of BP and vascular disease on target organ damage and CVD events. Although it requires refinement and validation in future studies, early detection of SHATS using tools such as the proposed score, combined with population-based stratification and technology-based anticipation medicine incorporating real-time individual data, has the potential to contribute to meaningful reductions in rates of CVD events and target organ damage.

中文翻译：

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系统性血流动力学动脉粥样硬化综合征（SHATS）-耦合血管疾病和血压变异性：来自亚洲脉搏的提议概念。

高血压（HTN）是心血管疾病（CVD）的重要危险因素，但是仅凭平均血压（BP）不能解释HTN和CVD之间的关联。BP变异性（BPV）以及HTN对脉管系统的影响是另一个重要因素。已经提出了系统性血流动力学动脉粥样硬化综合征（SHATS）的概念，其描述了血流动力学压力和血管疾病的年龄相关和协同的恶性循环。SHATS的重要性是基于这样的假设，即对BPV和动脉疾病的评估可能会提供有效的机会，尽早进行干预以减少年轻患者向HTN的进展或降低老年患者的CVD事件和器官损伤。除了概述有关SHATS的机制和临床数据的最新证据外，本文提出了一个新的SHATS分数，用于诊断和评估SHATS的严重性。该分数包括两个部分-BP分数和血管分数-乘以生成SHATS分数。这反映了BP和血管疾病对靶器官损伤和CVD事件的协同作用，而不是累加作用。尽管需要在以后的研究中进行完善和验证，但使用提议的得分等工具，结合基于人口的分层和结合实时个人数据的基于技术的预期医学，对SHATS进行早期检测，有可能有助于显着降低CVD事件的发生率和靶器官损伤。该分数包括两个部分-BP分数和血管分数-乘以生成SHATS分数。这反映了BP和血管疾病对靶器官损伤和CVD事件的协同作用，而不是累加作用。尽管需要在以后的研究中进行完善和验证，但使用提议的得分等工具，结合基于人口的分层和结合实时个人数据的基于技术的预期医学，对SHATS进行早期检测，有可能有助于显着降低CVD事件的发生率和靶器官损伤。该分数包括两个部分-BP分数和血管分数-乘以生成SHATS分数。这反映了BP和血管疾病对靶器官损伤和CVD事件的协同作用，而不是累加作用。尽管需要在以后的研究中进行完善和验证，但使用提议的得分等工具，结合基于人口的分层和结合实时个人数据的基于技术的预期医学，对SHATS进行早期检测，有可能有助于显着降低CVD事件的发生率和靶器官损伤。