Association of Cumulative Systolic Blood Pressure With Long-Term Risk of Cardiovascular Disease and Healthy Longevity: Findings From the Lifetime Risk Pooling Project Cohorts.
Association of Cumulative Systolic Blood Pressure With Long-Term Risk of Cardiovascular Disease and Healthy Longevity: Findings From the Lifetime Risk Pooling Project Cohorts.
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累积收缩压与心血管疾病长期风险和健康寿命的关系：来自终身风险汇总项目队列的发现
DOI：
10.1161/hypertensionaha.120.15650
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Allen NB
中科院分区：
文献类型：
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作者：
Reges O;Ning H;Wilkins JT;Wu CO;Tian X;Domanski MJ;Lloyd-Jones DM;Allen NB
高血压是心血管疾病的主要风险因素，但之前的研究大多局限于单一检查、单一队列、较短的随访期或有限数量的结果。这项研究旨在评估中年10年累计收缩压与任何心血管疾病、冠心病、中风、心力衰竭、全因死亡率和健康长寿的长期风险之间的关系。来自5个不同种族/民族的美国社区队列的个人(11,502人)一旦满足所有纳入标准就被纳入本研究：在纳入的队列中观察≥10年，年龄45-60岁，无心血管疾病，在之前10年内有3次≥就诊并进行过血压检查。对于每个参与者，根据可用的检查(中位数为4.0，分布在9.1(范围：7.2-10年))，对先前纳入的10年中的每一年的收缩压水平进行预测。较低的10年累积收缩压与较长的存活时间和5.4年的心血管疾病发病时间相关，从而导致较短的发病时间和较长的寿命。校正了社会人口学特征、心血管危险因素和收缩压指数的模型显示，10年累积收缩压(每130毫米汞柱×年变化，高血压的阈值)与心血管疾病(HR：1.28，95%CI：1.20-1.36)、冠心病(HR：1.29，95%CI：1.19-1.40)、中风(HR：1.33，95%CI：1.20-1.47)、心力衰竭(HR：1.12，95%CI：1.02-1.23)、全因死亡率(HR：1.21，95%CI：1.14~1.29)。这些发现强调了10年累计收缩压作为心血管疾病的危险因素的重要性，超过了当前的收缩压。
Hypertension is a major risk factor for cardiovascular disease, but previous studies have mostly been limited to a single exam, a single cohort, a short follow-up period, or a limited number of outcomes. This study aimed to assess the association of 10-year cumulative systolic blood pressure in middle age with long-term risk of any cardiovascular disease, coronary heart disease, stroke, heart failure, all-cause mortality, and healthy longevity. Individuals (11,502) from 5 racially/ethnically diverse US community-based cohorts were included in this study once they met all the inclusion criteria: ≥10yr of observation in the included cohort, aged 45-60yr, free of cardiovascular disease, and had ≥3 visits with blood pressure exams over the preceding 10yr. For each participant, systolic blood pressure level was predicted for each year of the 10yr prior inclusion, based on the available exams (Median of 4.0, spread over 9.1(range:7.2-10) years). Lower 10-year cumulative systolic blood pressure was associated with 4.1yr longer survival and 5.4yr later onset of cardiovascular disease, resulting in living longer life with a shorter period with morbidity. Models adjusted for sociodemographic characteristics, cardiovascular risk factors, and index systolic blood pressure demonstrated associations of 10-year cumulative systolic blood pressure (per 130 mmHg×yr change, the threshold for stage-1 hypertension) with cardiovascular disease (HR:1.28, 95%CI:1.20-1.36), coronary heart disease (HR:1.29, 95%CI:1.19-1.40), stroke (HR:1.33, 95%CI:1.20-1.47), heart failure (HR:1.12, 95%CI: 1.02-1.23), and all-cause mortality (HR:1.21, 95%CI:1.14-1.29). These findings emphasize the importance of 10-year cumulative systolic blood pressure as a risk factor to cardiovascular disease, above and beyond current systolic blood pressure.