Presence of baseline prehypertension and risk of incident stroke A meta-analysis
Presence of baseline prehypertension and risk of incident stroke A meta-analysis
复制标题
DOI：
10.1212/wnl.0b013e3182315234
复制
发表时间：
2011-10-01
期刊：
影响因子：
9.9
通讯作者：
Ovbiagele, B.
中科院分区：
文献类型：
--
作者：
Lee, M.;Saver, J. L.;Ovbiagele, B.
目的：通过前瞻性队列研究的荟萃分析，定性和定量评估高血压前期与卒中事件的关联。方法：我们检索了Medline、Embase、科克伦图书馆和检索到的文献的参考书目。前瞻性队列研究包括，如果他们报告多变量调整的相对危险度（RR）和相应的95%置信区间（CI）的中风相对于基线高血压前期。高血压前期与卒中风险相关（RR 1.55，95%CI 1.35-1.79; p < 0.001）。7项研究进一步区分了低血压前期人群（收缩压[SBP] 120-129 mm Hg或舒张压[DBP] 80-84 mm Hg）和高血压前期人群（SBP 130-139 mm Hg或DBP 85-89 mm Hg）。在低范围高血压前期人群中，卒中风险没有显著增加（RR 1.22，0.95-1.57）。然而，对于高血压前期范围内的值较高的人，中风的风险大大增加（RR 1.79，95%CI 1.49-2.16）。结论：高血压前期与较高的中风风险有关。这种风险主要由高血压前期范围内的较高值驱动，尤其与非老年人相关。有必要进行随机试验，以评估具有这种指定的人的血压降低的疗效。神经病学（R）2011;77：1330-1337
Objective: To qualitatively and quantitatively assess the association of prehypertension with incident stroke through a meta-analysis of prospective cohort studies.Methods: We searched Medline, Embase, the Cochrane Library, and bibliographies of retrieved articles. Prospective cohort studies were included if they reported multivariate-adjusted relative risks (RRs) and corresponding 95% confidence intervals (CI) of stroke with respect to baseline prehypertension.Results: Twelve studies with 518,520 participants were included. Prehypertension was associated with risk of stroke (RR 1.55, 95% CI 1.35-1.79; p < 0.001). Seven studies further distinguished a low prehypertensive population (systolic blood pressure [SBP] 120-129 mm Hg or diastolic blood pressure [DBP] 80-84 mm Hg) and a high prehypertensive population (SBP 130-139 mm Hg or DBP 85-89 mm Hg). Among persons with lower-range prehypertension, stroke risk was not significantly increased (RR 1.22, 0.95-1.57). However, for persons with higher values within the prehypertensive range, stroke risk was substantially increased (RR 1.79, 95% CI 1.49-2.16).Conclusions: Prehypertension is associated with a higher risk of incident stroke. This risk is largely driven by higher values within the prehypertensive range and is especially relevant in nonelderly persons. Randomized trials to evaluate the efficacy of blood pressure reduction in persons with this designation are warranted. Neurology (R) 2011;77:1330-1337