不同年龄人群超敏C反应蛋白与新发高血压的关联分析  

The association of high-sensitivity C-reactive protein with new-onset hypertension in different age groups

作　　者：郭子墨 吴瑾卉 李旭阳 杨爽 王桂萍 吴寿岭[4] 张琦[3] Guo Zimo;Wu Jinhui;Li Xuyang;Yang Shuang;Wang Guiping;Wu Shouling;Zhang Qi(Graduate School of North China University of Science and Technology,Tangshan 063000,China;Graduate School of Hebei Medical University,Shijiazhuang 050011,China;Department of Cardiology,Tangshangongren Hospital,Tangshan 063000,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学研究生院,唐山063000 [2]河北医科大学研究生院,石家庄050011 [3]唐山市工人医院心内科,唐山063000 [4]开滦总医院心内科,唐山063000

出　　处：《中华心血管病杂志》2022年第10期993-999,共7页Chinese Journal of Cardiology

摘　　要：目的探讨不同年龄段人群超敏C反应蛋白(hsCRP)水平与新发高血压的关联。方法该研究为前瞻性队列研究,纳入参加2006至2007年度健康体检的开滦集团社区非高血压人群。每2年随访1次,以新发高血压时间作为随访终点,未发现高血压者随访截止时间为死亡时间或随访结束时间(2017年12月31日)。根据基线hsCRP水平将被试者分为低风险组(hsCRP<1.0 mg/L)、中风险组(hsCRP≥1.0且≤3.0 mg/L)和高风险组(hsCRP>3.0 mg/L),并按年龄进一步分层(每10岁1组)。采用Kaplan-Meier法计算各组人群高血压累积发病率,采用多因素Cox回归模型分析hsCRP水平与新发高血压的关联。结果研究纳入51179人,其中男性38606人(75.43%),年龄(48.1±12.2)岁,基线hsCRP为0.64(0.25,1.60)mg/L。低、中、高风险组各31791、12419、6969人,基线hsCRP分别为0.30(0.16,0.59)、1.57(1.20,2.10)、5.17(3.80,7.10)mg/L。随访(8.1±2.2)年,期间共9523(18.60%)人新发高血压,低、中、高风险组人群的累积发病率分别为17.41%、20.48%、20.73%,低、中、高风险组<45、45~54、55~64、≥65岁人群高血压的累积发病率分别为13.53%、15.82%、16.76%,19.27%、22.84%、21.62%,21.55%、24.19%、24.88%,20.20%、22.35%、19.11%,除≥65岁人群外,其余各年龄段低、中、高风险组人群高血压累积发病率差异均有统计学意义(P均<0.05)。多因素Cox回归模型分析结果显示,在总人群中高风险组人群新发高血压的风险是低风险组人群的1.11倍(HR=1.11,95%CI 1.05~1.18);在<45岁、45~54岁、55~64岁和≥65岁人群中高风险组新发高血压的风险分别为低风险组的1.22倍(HR=1.22,95%CI 1.08~1.38)、1.14倍(HR=1.14,95%CI 1.04~1.26)、1.16倍(HR=1.16,95%CI 1.04~1.30)和1.02倍(HR=1.02,95%CI 0.86~1.20)。结论hsCRP高水平是新发高血压的危险因素,hsCRP升高所致高血压发病风险呈现出年龄依赖性。Objective To investigate the association between high sensitivity C-reactive protein(hsCRP)level and new-onset hypertension in different age groups.Methods This was a prospective cohort study involving non-hypertensive population in Kailuan Group community who participated in health examination between 2006 and 2007.Follow-up was conducted every 2 years,and the time of new onset of hypertension was used as the endpoint of follow-up.The endtime of follow-up for patients without hypertension was the time of death or the last follow-up(December 31,2017).According to the baseline hsCRP level,the participants were divided into low-risk group(hsCRP<1.0 mg/L),medium-risk group(hsCRP≥1.0 and≤3.0 mg/L),and high-risk group(hsCRP>3.0 mg/L),and further stratified by age.Kaplan-Meier method was used to calculate the cumulative incidence of hypertension in each group.Multivariate Cox regression model was used to analyze the association between hsCRP level and new-onset hypertension.Results A total of 51179 participants were included in this study,including 38606 males(75.43%)with an average age of(48.1±12.2)years.The baseline hsCRP was 0.64(0.25,1.60)mg/L.The baseline hsCRP was 0.30(0.16,0.59),1.57(1.20,2.10),5.17(3.80,7.10)mg/L respectively in low-,medium-and high-risk groups.During the follow-up of(8.1±2.2)years,a total of 9523(18.60%)patients developed hypertension,and the cumulative incidence rates of low-,medium-and high-risk groups were 17.41%,20.48%and 20.73%,respectively.The cumulative incidence of hypertension in low-,medium-and high-risk groups of<45,45-54,55-64,≥65 years old were 13.53%,15.82%,16.76%;19.27%,22.84%,21.62%;21.55%,24.19%,24.88%;20.20%,22.35%,19.11%,respectively.Except for people aged≥65 years,there were significant differences in the cumulative incidence of hypertension in low-,medium-and high-risk groups(all P<0.05).Multivariate Cox regression analysis showed that the risk of new-onset hypertension in the high risk group was 1.11 times higher than that in the low risk group(HR=1.11,95%CI 1.0

关 键 词：高血压 C反应蛋白 年龄组 

分 类 号：R544.1[医药卫生—心血管疾病]