正常高值血压对糖尿病人群高血压发病的影响  

Impact of prehypertension on newly-onset hypertension in diabetic patients

作　　者：孙静[1] 宋黎明[1] 吴雷[2] 黄玉艳[1] 张晓辉[3] 刘鹏[4] 王德胜[5] 王志彬[1] 吴寿岭[6] 

机构地区：[1]开滦总医院林西医院心内科,唐山063000 [2]开滦总医院林西医院心呼吸普外科,唐山063000 [3]开滦总医院林西医院心呼吸内科,唐山063000 [4]开滦总医院林西医院心儿科,唐山063000 [5]开滦总医院林西医院心功能科,唐山063000 [6]河北联合大学附属开滦总医院心内科

出　　处：《中华内分泌代谢杂志》2014年第2期110-114,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：河北省医学科学研究重点课题计划项目（20110632）

摘　　要：目的探讨正常高值血压对糖尿病人群高血压的发病影响。方法选择2006年6月至2007年10月健康体检的101510名开滦集团在职及离退休职工中空腹血糖≥7．0mmol/L或〈7．0mmoUL但已确诊为糖尿病，正在使用降糖药物者共9489例，选择血压为〈140／90mmHg（1mmHg：0．133kPa）的糖尿病者作为观察人群。于（25．5±4．7）个月（12～39个月）后进行第2次健康体检，测量血压并计算发病率，用logistic回归模型分析影响高血压发病的因素。结果对2367例观察对象总随访5013．15人年，于第2次体检时有908例进展为高血压，糖尿病人群高血压的发病率为18．1／100人年，男性高于女性（19．1／100人年对14．3／100人年）。正常高值组的发病率高于正常血压组（20．4／100人年对11．6／100人年）。按照〈40岁、40～50岁、50～60岁和≥60岁年龄组，高血压发病率分别为15．0／100人年、17．6／100人年、18．7／100人年、18．6／100人年，其中正常高值组的高血压发病率分别为17．2／100人年、20．1／100人年、20．8／100人年、20．9／100人年。，校正相关因素后．影响糖尿病人群进展为高血压的危险因素的包括正常高值血压（RR=1．50，95％CI1．15-1．95）、男性（RR=1．36，95％CI1．06-1．75）、年龄50～60岁（RR=1．79，95％C，1．22-2．63）、年龄≥60岁（RR=1．85．95％CI1．22-2．80）、收缩压（RR=1．77，95％CI1．42-2．20）、体重指数（RR：1．54，95％C11．23-1．93）和尿酸（RR=1．31，95％CI1．04-1．65）。结论正常高值血压是影响糖尿病人群高血压发病的独立危险因素，其高血压发病率随年龄增加而递增。男性、年龄、收缩压、体重指数和尿酸也是影响糖尿病人群进展为高血压的危险因素。Objective To explore the impact of prehypertension on the new-onset hypertension in diabetic patients. Methods The data were derived from 101 510 active and retired employees of Kailuan Group who took part in the health examination from July 2006 to October 2007. Those whose fasting plasma glucose ≥ 7.0 mmol/L or whose fasting plasma glucose 〈7.0 mmol/L but with diagnosed diabetes treated with hypoglycemic medication or insulin, and those with blood pressure levels〈140/90 mmHg（ 1 mmHg =0. 133 kPa） were enrolled in this study. After （25.5 -＋ 4.7 ） months （ 12-39 months ） , a second health examination was carried out. Their blood pressures were measured and the incidence of hypertension was calculated. The influencing factors in hypertension were analyzed by Logistic regression model. Results On the repeated health examination, 908 of 2 367 subjects developed hypertension after follow-up 5 013. 15 person-year. The incidence of hypertension was 18. 1 per 100 person-year. The incidence was higher in males than in females （19. 1 per 100 person-year vs 14. 3 per 100 person-year）, also higher in prehyperteusive group than in normotensive group （ 20.4 per 100 person-year vs 11.6 per 100 person-year ）. The hypertension incidences in the subjects aged 〈40,40-50, 50-60, and ~〉60 were respectively 15.0, 17.6, 18.7, and 18.6 per 100 person-year. While in the prehypertensive group the corresponding incidences were respectively 17.2, 20.1,20.8, and 20.9 per 100 person-year. After adjustment for other risk factors, binary logistic regression showed that the correlated factors for hypertension were prehypertension（ RR = 1.50,95 % CI 1.15-1.95 ） , male（ RR = 1.36, 95% CI 1.06-1.75）, age ranges of 50-60（RR= 1.79, 95% CI 1.22-2.63 ） and ≥60 （ RR = 1.85, 95% CI 1.22- 2.80） , systolic blood pressure（ SBP; RR= 1.77, 95% CI1.42-2.20） , body mass index（ BMI; RR= 1.54, 95% CI 1.23-1.93）, and plasma uric acid （ UA; RR = 1. 31, 95% CI 1.04-1.65）. Conclusion Prehypertension is the

关 键 词：糖尿病 高血压 发病率 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]