Moderate and Severe Blood Pressure Elevation Associated with Stroke in the Mexican Hispanic Population.
Moderate and Severe Blood Pressure Elevation Associated with Stroke in the Mexican Hispanic Population.
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DOI：
10.4236/health.2017.96068
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发表时间：
2017-06
期刊：
影响因子：
2.1
通讯作者：
Zhang J
中科院分区：
文献类型：
--
作者：
Senior D;Osborn MF;Tajnert K;Badr A;Dwivedi AK;Zhang J
中风是美国第四大死因。在年龄、性别、种族、遗传、肥胖、糖尿病等其他因素中，高血压仍然是导致中风的主要因素。关于拉美裔美国人中风的研究很少，也没有定论。本研究的目的是在墨西哥拉美裔人群中调查血压升高与缺血性中风风险之间的潜在联系。对病例对照研究进行了回顾性数据分析，病例对照比为1：2。墨西哥裔病例来自ElPasoStroke数据库，诊断为高血压并持续了缺血性卒中(n=505)，墨西哥拉美裔病例为2005-2010年NHANES数据库中未发生中风的对照(n=1010)。在这项分析中，我们包括有病例(327例)和对照组(772例)的动脉收缩压、舒张压或平均动脉压数据的受试者。在病例中，血压是通过首次入院测量来确定的，而在对照组中，使用的是第一次测量的血压。通过Logistic回归分析，确定连续测量动脉收缩压、舒张压和平均动脉压对卒中的未调整和调整效果。受试者进一步根据高血压前期和高血压范围进行分组，这是由国家高血压预防、检测、评估和治疗联合委员会(JNC7)建立的。未调整和调整的Logistic回归模型也被用来确定分类血压的效果。我们的数据表明，在墨西哥拉美裔人群中，每单位收缩压、舒张压或平均动脉压的增加会增加中风的风险。对分类血压的调整分析表明，轻度或中度/重度高血压与中风的几率显著相关。将血压维持在更严格和更低的水平，特别是降低平均动脉压，可能有效地降低墨西哥拉美裔人口中缺血性中风的几率。血压升高增加了墨西哥拉美裔人口中风的几率。我们的结果为管理墨西哥拉美裔人群中的中风预防和健康差距问题提供了新的战略。
Stroke is the fourth leading cause of death in US. Amongst other factors such as age, sex, race, genetics, obesity, diabetes etc., hypertension continues to be the leading contributing factor towards stroke. Studies regarding stroke in Hispanics are sparse and inconclusive. The objective of the present study is to investigate the potential association between blood pressure elevation and risk of ischemic stroke among the Mexican Hispanic population. A retrospective data analysis was carried out for a planned case-control study with case-control ratios of 1:2. Mexican Hispanic cases were from the ElPasoStroke database with diagnosed hypertension that had sustained an ischemic stroke (n = 505) and Mexican Hispanics diagnosed with hypertension who were stroke-free as controls from the 2005–2010 NHANES databases (n = 1010). In this analysis, we included subjects who had data on systolic, diastolic or mean arterial blood pressures for cases (327) and controls (772). In cases, blood pressure was determined by the initial admission measurement, and in controls, the first measured blood pressure was used. The unadjusted and adjusted effects of continuous measurements of systolic, diastolic and mean arterial blood pressure on stroke were determined using logistic regression analyses. Subjects were further classified into groups based on prehypertension and hypertension ranges, as established by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7). Unadjusted and adjusted logistic regression models were also used to determine the effect of categorized blood pressures. Our data indicate that per unit increase in systolic, diastolic or mean arterial blood pressure elevates the odds of stroke among the Mexican Hispanic population. Adjusted analysis of categorized blood pressures showed that mild or moderate/severe high blood pressure significantly associated with odds of stroke. Maintaining and controlling blood pressure at more stringent and lower levels, specifically lowering mean arterial pressure may effectively reduce the odds of ischemic stroke among the Mexican Hispanic population. Elevation of blood pressure increases the odds of stroke among the Mexican Hispanic population. Our results provide new strategies to manage the stroke prevention and health disparity issues among the Mexican Hispanic population.