中国11省市队列人群基线血压和7年累积心血管病发病危险的前瞻性研究  

Association between blood pressure level and risk of cardiovascular diseases in Chinese: a cohort study in 11 provinces of China

作　　者：赵冬[1] 吴兆苏[1] 王薇[1] 刘静[1] 吴桂贤[1] 曾哲淳[1] 王文化[1] 刘军[1] 秦兰萍[1] 刘飒[1] 

机构地区：[1]北京心肺血管疾病研究所安贞医院流行病研究室,100029

出　　处：《中华心血管病杂志》2001年第10期612-617,共6页Chinese Journal of Cardiology

基　　金：国家"八五"医学科技攻关课题 ( 85 915 0 1 0 2 )

摘　　要：目的　以较大人群、较广的地理覆盖面的前瞻性队列研究结果提供中国人血压水平与心血管病发病危险量化关系的数据 ;探讨收缩压和舒张压作为危险因素标识或致病因素在与心血管病的发病危险的关系上存在的差别 ;分析血压对急性脑卒中和冠心病事件发病的影响是否存在差别及控制血压对预防这两种疾病的公共卫生意义 ;初步评价现行的高血压诊断、治疗和分级标准。方法　对 1992年建立的 11省市 35～ 6 4岁队列人群共 2 9488人基线血压水平和 1992～ 1999年共 138177 1观察人年中急性心血管病 (包括脑卒中和冠心病 )事件发病的数据进行单因素和多因素分析。结果对收缩压和舒张压分别进行的单因素和多因素分析显示 ,两者均可作为预测急性心血管病事件发病危险的有效标识 ,但收缩压水平对急性心血管病事件 ,特别是脑卒中危险的影响强度明显大于舒张压 ,收缩压≥ 180mmHg(1mmHg =0 133kPa)组与收缩压 <12 0mmHg组人群相比 ,急性心血管事件发病危险单因素分析时高 2 2倍 (脑卒中 31倍 ,冠心病 8倍 ) ,多因素分析时高 11倍 (脑卒中 16倍 ,冠心病 4倍 )。血压对于与急性脑卒中事件和急性冠心病事件的影响无论在强度、影响方式和预防的公共卫生意义上存在明显差别 ,人群中 79 7%的脑卒中事件可归因于血压的升高 ,但?Objective To determine the quantitative relationship between baseline blood pressure (BP) levels and the seven years′ accumulative risk of events of cardiovascular diseases (CVD); to examine the differences between systolic blood pressure (SBP) and diastolic blood pressure (DBP) for the CVD risk as either the markers or the independent risk factors; to analyze if there are some differences in patterns of the association between BP and acute stroke event; to assess if the diagnostic criteria used currently for hypertension are appropriate to Chinese. Methods The baseline blood pressure levels of 29 488 subjects aged 35-64 from 11 provinces of China and the incidence rates of CVD events during the follow-up period were analyzed. Results Both SBP and DBP were the good markers for predicting risk of acute cardiovascular events in Chinese population. SBP was the better marker and stronger independent risk factor for CVD risk than DBP. The CVD event rate was 22 times higher in univariate analysis and 11 times higher in multivariate analysis in the group of people with SBP≥180 mm Hg, comparing with that in the group of SBP<120 mm Hg. There were significant differences in strength and pattern of association between BP and different CVD events, and in the potential of hypertension control for prevention of stroke and coronary diseases. Up to 79.7% total stroke events and 36.6% total coronary events among the cohort population could be attributed to the rising BP level. Conclusion Currently, hypertension is the most important risk factor of CVD for Chinese. Prevention and control of hypertension would be the key strategy for effective reduction of CVD burden in China.

关 键 词：血压 脑血管意外 冠状动脉疾病 队列研究 心血管疾病 前瞻性研究 

分 类 号：R195[医药卫生—卫生统计学]