北京市社区人群正常高值血压与颈动脉硬化的关系  

Relationship between high normal blood pressure and carotid artery atherosclerosis in Beijing residents

作　　者：马为[1] 杨颖[1] 齐丽彤[1] 张宝娓[1] 孟磊[1] 张岩[1] 蒋捷[1] 李建平[1] 王淑玉 霍勇[1] 

机构地区：[1]北京大学第一医院心内科,100034 [2] 北京市高血压联盟

出　　处：《中华心血管病杂志》2014年第6期510-514,共5页Chinese Journal of Cardiology

基　　金：基金项目：“十一五”科技支撑计划（2006BAI01A02）

摘　　要：目的 分析北京市社区人群正常高值血压与颈动脉硬化的关系.方法 2007至2008年,在北京市石景山地区2个社区进行流行病学调查,共入选研究对象3 324名,选择颈动脉资料齐全者2 895名进行分析.调查相关心血管危险因素,包括血脂、血压、高敏C反应蛋白、体质指数.采用超声测量平均颈动脉内中膜厚度（IMT）、最大IMT及颈动脉斑块.以多因素logistic回归分析正常高值血压与颈动脉硬化的关系.结果 颈动脉平均和最大IMT、斑块发生率以及各血管段平均和最大IMT随着血压水平增高而增加（P均＜0.01）.调整糖尿病、高胆固醇血症、高甘油三酯血症、高敏C反应蛋白增高、吸烟、性别、年龄、超重、肥胖后,多因素logistic回归分析显示,以正常血压患者为对照,正常高值血压患者的平均IMT、最大IMT增厚及颈动脉斑块的OR值分别为4.50（95％ CI：1.04～19.49,P＜0.05）、1.73（95％CI：1.35～2.22,P＜0.01）和1.64（95％CI：1.26～2.13,P＜0.01）.结论 正常高值血压与颈动脉硬化独立相关.Objective To analyze the relationship between normal high blood pressure and carotid artery atherosclerosis.Methods This epidemiological survey was performed in two communities of Shijingshan District of Beijing from 2007 to 2008.A total of 3 324 people were enrolled in the study and 2 895 people with carotid ultrasound survey results were analyzed.Blood lipids,blood pressure,hs-CRP,body mass index （BMI） and other cardiovascular risk factors were obtained.Carotid mean intima-media thickness （IMT）,maximum carotid IMT and carotid plaque were measured by ultrasound.A multiple logistic regression model was used to evaluate the relationship between normal high blood pressure and carotid artery atherosclerosis.Results The carotid mean IMT,maximum IMT,incidence of carotid artery plaque increased in proportion to blood pressure level （all P 〈 0.01）.After adjusting for diabetes,hypercholesterolemia,hypertriglyceridemia,increased hs-CRP,smoking,sex,age,overweight and obesity,multiple logistic regression analysis showed that the OR values of carotid mean IMT and maximum IMT thickening,carotid plaque in high normal blood pressure group were 4.50 （95% CI：1.04-19.49,P 〈 0.05）,1.73 （95%CI：1.35-2.22,P〈0.01）,1.64 （95%CI：1.26-2.13,P〈0.01） compared tonormal blood pressure group.Conclusion High normal blood pressure is related with higher risk of carotid artery atherosclerosis in this cohort.

关 键 词：血压 颈动脉疾病 动脉硬化 

分 类 号：R544.1[医药卫生—心血管疾病] R543.4[医药卫生—内科学]