中心动脉收缩压与中国动脉粥样硬化性心血管病风险预测研究模型评估的心血管病10年风险的关系  

Association between central systolic blood pressure and a 10-year cardiovascular risk estimated by the model of prediction for arteriosclerotic cardiovascular disease risk in China

作　　者：李锴印 范芳芳[1,2,3] 贾佳[1,2,3] 李建平[1,2,3] 张岩[1,2,3] 霍勇[1] LI Kai-yin;FAN Fang-fang;JIA Jia;LI jian-ping;ZHANG Yan;HUO Yong(Department of Cardiology,Peking University First Hospital,Beijing 100034,China;Institute of Cardiovascular Disease,Peking University First Hospital,Beijing 100034,China;Hypertension Precision Diagnosis and Treatment Research Center,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院心内科,北京100034 [2]北京大学心血管疾病研究所,北京100034 [3]北京大学高血压精准诊疗研究中心,北京100034

出　　处：《中华高血压杂志》2023年第1期45-51,共7页Chinese Journal of Hypertension

基　　金：国家重点研发计划项目(2021YFC2500503);北京大学医学部-密歇根大学医学院转化医学与临床研究联合研究所和中央高校基本科研业务费资助项目(BMU20110177,BMU20160530);首都卫生发展科研专项(2020-2-2053);分子心血管学教育部重点实验室(北京大学);国家卫生健康委员会心血管分子生物学与调节肽重点实验室。

摘　　要：目的探究无创中心动脉收缩压(cSBP)与中国动脉粥样硬化性心血管病风险预测研究(China-PAR)模型评估的心血管病10年风险(China-PAR 10年风险)的相关性。方法2018年9-12月对北京市石景山区动脉粥样硬化人群队列进行随访调查,从中筛选cSBP和China-PAR模型所需数据完整、无冠状动脉粥样硬化性心脏病(冠心病)及脑卒中病史的研究对象共2051例。cSBP通过Omron HEM-9000AI测量获得。10年心血管病风险通过China-PAR模型计算获得,其风险<5.0%、5.0%~<10.0%、≥10.0%分别定义为低、中、高风险。采用单因素和多因素线性回归分析cSBP水平与China-PAR 10年风险的相关性,采用单因素和多因素logistic回归分析cSBP水平与China-PAR 10年风险是否为高风险的相关性。结果cSBP第1、2、3三分位组China-PAR 10年风险分别为5.05%(2.93%~8.77%)、8.23%(5.05%~12.55%)、11.67%(7.41%~17.27%)。随着cSBP升高,China-PAR 10年风险显著升高(χ^(2)=368.85,P<0.01)。多因素线性和logistic回归分析显示,调整协变量后,cSBP每增加10 mm Hg,China-PAR 10年风险增加0.95%(B=0.95,95%CI 0.80~1.10),10年心血管病高风险的比例增加36%(OR=1.36,95%CI 1.26~1.46);与cSBP最低三分位组相比,第2三分位组的China-PAR 10年风险增加1.06%(B=1.06,95%CI 0.48~1.64),10年心血管病高风险的比例增至1.82倍(OR=1.82,95%CI 1.34~2.47),最高三分位组的China-PAR 10年风险增加3.20%(B=3.20,95%CI 2.56~3.84),10年心血管病高风险的比例增至3.22倍(OR=3.22,95%CI 2.35~4.42)。进一步去除正在服用降压药的人群后,二者的相关性仍有统计学意义。结论在北京社区人群中,无创cSBP越高,China-PAR 10年风险越高,提示无创cSBP对预测国人10年心脑血管事件具有重要意义。Objective To investigate the association between central systolic blood pressure(cSBP)and the 10-year cardiovascular risk estimated by the model of prediction for arteriosclerotic cardiovascular disease risk in China(China-PAR).Methods The data from the follow-up survey of the cohort of atherosclerotic people in Shijingshan District of Beijing from September to December 2018 were used.After excluding those with history of coronary heart disease and stroke,2051 participants with effective data of cSBP and other information required for China-PAR risk prediction model were selected in the analysis.cSBP was measured using Omron HEM-9000AI.The 10-year cardiovascular risk was estimated by China-PAR risk prediction model,and low,moderate and high risks were defined as the estimated risk<5.0%,5.0%-<10.0%and≥10.0%,respectively.Univariate and multivariate linear regression analysis were used to analyze the correlation between cSBP level and China-PAR 10-year risk,and univariate and multivariate logistic regression analysis were used to analyze the correlation between cSBP level and high 10-year cardiovascular risk.Results The 10-year risk of the first,second and third tertile of cSBP was 5.05%(2.93%-8.77%),8.23%(5.05%-12.55%)and 11.67%(7.41%-17.27%),respectively.As cSBP elevated,the estimated 10-year cardiovascular risk significantly increased(χ^(2)=368.85,P<0.01).Multivariate linear and logistic regression analysis showed that after adjusting for covariates,compared with participants in the first tertile of cSBP,the estimated 10-year risk increased by 1.06%(B=1.06,95%CI 0.48-1.64)among participants in the second tertile and 3.20%(B=3.20,95%CI 2.56-3.84)in the third tertile,and the rate of a high risk increased by 1.82 times(OR=1.82,95%CI 1.34-2.47)among participants in the second tertile and 3.22 times(OR=3.22,95%CI 2.35-4.42)in the third tertile.For every 10 mm Hg elevation in cSBP,the estimated 10-year risk increased by 0.95%(B=0.95,95%CI 0.80-1.10),and the rate of a high risk increased by 1.36 times(OR=1.36,95%CI 1

关 键 词：心血管病 风险评估 中国动脉粥样硬化性心血管病风险预测研究(China-PAR)模型 无创中心动脉收缩压 

分 类 号：R543.5[医药卫生—心血管疾病]