新疆南疆地区农村人群基于不同指南定义的单纯舒张期高血压与心血管疾病的关联  

Association between isolated diastolic hypertension and cardiovascular diseasebased on different guideline definitions in a rural population in southern Xinjiang

作　　者：程静 孙雪莹 马儒林[1] 何佳[1] 丁玉松[1] 芮东升[1] 李毓 任罗艺 郭淑霞[1,2] 郭恒 CHENG Jing;SUN Xueying;MA Rulin;HE Jia;DING Yusong;RUI Dongsheng;LI Yu;REN Luoyi;GUO Shuxia;GUO Heng(Department of Public Health,Shihezi University School of Medicine,Shihezi,Xinjiang 832000,China;Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security,the Xinjiang Production and Construction Corps,Shihezi,Xinjiang 832000,China;The First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 832000,China)

机构地区：[1]石河子大学医学院预防医学系,新疆石河子832000 [2]重要新发传染病防控与公共卫生安全兵团重点实验室,新疆石河子832000 [3]石河子大学第一附属医院,新疆石河子832000

出　　处：《石河子大学学报（自然科学版）》2024年第3期342-348,共7页Journal of Shihezi University(Natural Science)

基　　金：新疆生产建设兵团重点领域科技攻关计划(2021AB030)。

摘　　要：目的探索新疆南疆地区农村人群中基于不同指南定义的单纯舒张期高血压(IDH)与心血管疾病(CVD)风险的关联。方法以新疆生产建设兵团第三师51团常住人口作为研究对象。根据2017年美国心脏病学会/美国心脏协会(ACC/AHA)高血压指南和2020年中国高血压指南对IDH的定义,分别纳入研究对象6834人和8960人。采用Log-rank检验比较不同指南定义的IDH患者和血压正常者CVD事件累积发病率的差异;使用Cox比例风险回归模型探索IDH与CVD风险的关联。结果ACC/AHA指南所定义的IDH患病率比中国指南定义者高5.4%。两种指南定义的IDH患者与血压正常者的CVD累积发病率差异均无统计学意义(ACC/AHA指南,χ2=0.07,P=0.80;中国指南,χ2=3.85,P=0.05);ACC/AHA指南定义的IDH患者CVD累积发病率较中国指南定义者低(6.14%vs 9.88%,χ2=5.22,P=0.02)。与血压正常者相比,中国指南定义的IDH与CVD发生风险的关联强度高于ACC/AHA指南,但差异无统计学意义,HR(95%CI)分别为:1.411(0.999~1.993)、1.037(0.788~1.364)。结论在新疆南疆农村人群中,应用2017年ACC/AHA指南定义的血压新阈值能够筛选出更多的IDH患者,有利于早期采取有效的防控措施。Objective To explore the association between isolated diastolic hypertension(IDH)based on different guideline definitions and the risk of cardiovascular disease(CVD)in rural areas of southern Xinjiang.Methods The resident population of the third division of the Xinjiang Production and Construction Corps was selected as the study population.According to the definition of IDH in the 2017 American College of Cardiology/American Heart Association(ACC/AHA)guideline and the 2020 Chinese Hypertension Guideline,6834 and 8960 study subjects were included,respectively.The Log-rank tests were used to compare the differences in the cumulative incidence of CVD events between patients with IDH defined by different guidelines and normotensive participants;Cox proportional risk regression models were used to examine the association between IDH and CVD risk.Results The prevalence of IDH as defined by the ACC/AHA guidelines was 5.4%higher than those defined by the Chinese guidelines.None of the differences in the cumulative prevalence of CVD between IDH patients with different guideline definitions and normotensive participants were statistically significant(ACC/AHA guideline,χ2=0.07,P=0.80;Chinese guideline,χ2=3.85,P=0.05).The cumulative incidence of CVD in IDH patients under the ACC/AHA guideline definition was lower than that of those under the Chinese guideline definition(6.14%vs 9.88%,χ2=5.22,P=0.02).Compared with normotensive individuals,the strength of the association between IDH and CVD risk as defined by the Chinese guideline was higher than that defined by the ACC/AHA guideline,but the difference was not statistically significant,HR(95%CI):1.411(0.999~1.993),1.037(0.788~1.364).Conclusions In the rural population of southern Xinjiang,the application of the new blood pressure threshold defined by the 2017 ACC/AHA guidelines can screen out more patients with IDH,which is conducive to early and effective prevention and control measures.

关 键 词：单纯舒张期高血压 心血管疾病 队列研究 血压 

分 类 号：R18[医药卫生—流行病学]