单纯收缩期高血压对老年人群心脑血管事件的影响  

The influence of isolated systolic hypertension on the cardiovascular events in elderly people

作　　者：吴寿岭[1] 黄卫[1] 戚长春[1] 高竞生[1] 郑晓明[1] 王艳秀[1] 钟吉文[1] 张颖[1] 孙玉艳[1] 

机构地区：[1]河北联合大学附属开滦医院心内科,河北唐山063000

出　　处：《中华高血压杂志》2012年第1期67-71,共5页Chinese Journal of Hypertension

摘　　要：目的观察单纯收缩期高血压(ISH)对老年人群心脑血管事件的影响。方法采用前瞻性队列研究方法,以参加2006-07-2007-10健康查体的开滦集团在职及离退休职工101510人中年龄≥60岁,符合中国高血压防治指南2010ISH诊断标准(5321例)和正常血压诊断标准(2226例)的人群作为观察队列。随访38～53(49.5±2.7)月,随访期间每半年收集1次新发心脑血管事件情况。观察ISH在老年人群中心脑血管事件发生率并用多变量Cox比例风险回归模型分析影响心脑血管事件的因素。结果①与正常血压组相比,ISH组的平均年龄较大,三酰甘油、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、尿酸和体质量指数水平高,差异均有统计学意义(P<0.05)。②随访期间共发生383例心脑血管事件。在老年人群中,ISH组中总心脑血管事件、急性心肌梗死、脑梗死、脑出血和心脑血管病死亡的累积发生率分别为5.84%、1.32%、2.89%、0.66%和1.50%,高于正常血压组的3.23%、0.49%、1.66%、0.27%和1.21%,其中总心脑血管事件、急性心肌梗死、脑梗死和脑出血的事件累积发生率两组人群差异有统计学意义(P<0.05)。③多变量Cox比例风险回归模型表明,校正其他传统心血管危险因素后,ISH组发生总心脑血管事件、急性心肌梗死和脑梗死的RR分别是正常血压组的1.69倍(95%CI1.21～2.35),2.30倍(95%CI1.02～5.23)和1.64倍(95%CI1.03～2.61)。结论老年ISH是总心脑血管事件、急性心肌梗死和脑梗死事件的独立危险因素。Objective To observe the influence of isolated systolic hypertension on the cardiovascular events in elderly people. Methods The data used in this paper was derived from the KaiLuan study cohort. A total of 5321 isolated systolic hypertensives and 2226 normotensives（aged over 60 years old）were recruited,exclusion criteria included previous cardiovascular disease and unavailable information. Cardiovascular events including cerebral infarction,cerebral hemorrhage,acute myocardial infarction and definite fatal cardiovascular disease were recorded every 6 months during the follow-up[（49.5±2.7）months]. Cox proportional hazard ratios were calculated to assess relative risk of incident cardiovascular events. Results ①Compared with the group of normotension,the average age of the group of isolated systolic hypertension and the level of triglyceride,total cholesterol,low density lipoproteincholesterol（LDL-C）,fasting plasma glucose,uric acid and body mass index are higher（P0.05）. ②The median duration of follow-up was 49months（maximum,53 months）,during which 383cardiovascular events were recorded.In the group of isolated systolic hypertension,the incidence rate of cardiovascular events,acute myocardial infarction,cerebral infarction,cerebral hemorrhage,and definite fatal cardiovascular disease of the older adult people was 5.84%,1.32%,2.89%,0.66% and 1.50% respectively. While in normotensives,the corresponding incidence rate was 3.23%,0.49%,1.66%,0.27%and 1.21%,among which the difference between the accumulated occurrence of cardiovascular events,acute myocardial infarction,cerebral infarction and cerebral hemorrhage of the two groups were statistical significance（P0.05）.③After adjustment for other traditional cardiovascular risk factors,in the group of isolated systolic hypertension,the relative risk of the total cardiovascular events,acute myocardialinfarction and cerebral infarction are 1.69times（95% CI1.21-2.35）,2.30times（95%CI1.02-5.23）and 1.64 times（95% CI1.03-2.61）of those i

关 键 词：单纯收缩期高血压 心脑血管事件 队列研究 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]