| 邢凤梅,董岩,陶杰,高新颖,周剑辉,陈朔华,季春鹏,姚涛,吴寿岭.单纯舒张期高血压对新发心脑血管事件的影响[J].中华流行病学杂志,2014,35(8):956-960 |
| 单纯舒张期高血压对新发心脑血管事件的影响 |
| Impact of isolated diastolic hypertension on new-onset cardiovascular and cerebro-vascular diseases |
| 收稿日期:2014-02-24 出版日期:2014-08-30 |
| DOI：10.3760/cma.j.issn.0254-6450.2014.08.018 |
| 中文关键词: 心脑血管事件 单纯舒张期高血压 队列研究 |
| 英文关键词: Cardio-cerebral vascular events Isolated diastolic hypertension Cohort study |
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| 中文摘要: |
| 目的 探讨单纯舒张期高血压（IDH）对新发心脑血管事件（CVD）的影响。方法 采用队列研究方法，以参加2006-2007年度开滦集团公司职工健康体检的101 510例职工中符合“中国高血压防治指南（2010）”正常血压诊断标准（19 460例）及正常血压高值诊断标准（35 448例）、IDH诊断标准（6 780例）的既往无脑梗死、脑出血、蛛网膜下腔出血、心肌梗死、恶性肿瘤病史的61 688例作为观察队列，随访0.5～62.0（47.1±4.8）个月，随访期间每半年收集1次CVD情况。用寿命表法计算正常血压组、正常高值组、IDH组新发CVD的累积发病率，并用log-rank法检验及多变量Cox比例风险回归模型分析IDH对CVD的影响。结果 （1）随访期间，IDH组的总CVD（1.7%）、心肌梗死（0.3%）、脑梗死（1.0%）、脑出血累积发病率（0.4%）均高于正常血压组（0.9%、0.2%、0.6%、0.1%），两组总CVD、脑梗死事件、脑出血累积发病率差异有统计学意义（P<0.05）。（2）校正相关因素后，IDH组发生总CVD、脑梗死、脑出血的HR值分别是正常血压组的1.67倍（95%CI：1.28～2.17）、1.59倍（95%CI：1.12～2.27）和2.67倍（95%CI：1.54～4.65）。（3）对年龄进行分层分析，在<60岁组，校正后IDH组发生脑梗死的HR值为2.22（95%CI：1.41～3.50）；在≥60岁组，校正后IDH组发生脑出血的HR值为7.27（95%CI：2.58～20.42）。结论 IDH是总CVD、脑梗死、脑出血的独立预测因子，在不同的年龄层人群中，IDH对不同心脑血管事件的预测价值不同。 |
| 英文摘要: |
| Objective To explore the impact of isolated diastolic hypertension(IDH) on new-onset cardio-cerebral vascular diseases (CVD). Methods This cohort study involved 101 510 participants who were employees of the Kailuan Group-a state-run coal mining company,in 2006 and 2007. Among them,6 780 subjects were diagnosed with IDH,35 448 subjects were diagnosed with high-normal blood pressure and 19 460 subjects were diagnosed with normal tension. However,none of them had the history of either cardio-cerebral vascular disease or malignant cancer. Cardio-cerebral vascular events including cerebral infarction,cerebral hemorrhage,acute myocardial infarction were recorded every 6 months during the follow-up(47.1±4.8)period. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events. Results 1) There were 675 CVD events occurred during the follow-up period．The incidence rates of CVD events (1.7% vs. 0.9%),cerebral infarction (1.0% vs. 0.6%) and cerebral hemorrhage (0.4% vs. 0.1%) were significantly higher in IDH group than that in the normal tension group (all P<0.05). 2) After adjustment for other established CVD risk factors,the hazards ratios became 1.67(95%CI:1.28-2.17) for total CVD events and 1.59(95%CI:1.12-2.27)for cerebral infarction and 2.67(95%CI:1.54-4.65) for cerebral hemorrhage in the IDH group. 3) In stratified analysis on age,after adjustment for other established CVD risk factors,the hazards ratio was 2.22(95%CI:1.41-3.50) for cerebral infarction in lower 60 years old group,while the it was 7.27(95%CI:2.58-20.42) for cerebral hemorrhage in groups older than 60 years of age. Conclusion IDH was the independent risk factor for the total cardio-cerebral vascular events, on both cerebral infarction and cerebral hemorrhage. The predicted values of IDH for different CVD events were diverse on different age groups. |
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