Association of Sustained Blood Pressure Control with Multimorbidity Progression Among Older Adults.
Association of Sustained Blood Pressure Control with Multimorbidity Progression Among Older Adults.
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DOI：
10.1111/jgs.16558
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发表时间：
2020-09
影响因子：
6.3
通讯作者：
Muntner P
中科院分区：
文献类型：
--
作者：
Bowling CB;Sloane R;Pieper C;Luciano A;Davis BR;Simpson LM;Einhorn PT;Oparil S;Muntner P
由于与多发病相关的高成本和过高的死亡率，有必要开发延缓其进展的方法。高血压(BP)是一种常见的慢性病，也是许多其他慢性病的危险因素，使其成为干预的理想目标。这项分析的目的是确定持续的血压控制水平与多发性疾病进展之间的联系。回顾性队列研究。与医疗保险声明相关的抗高血压和降脂治疗预防心脏病发作试验(ALLHAT)。6,591名参加医疗保险的ALLHAT参与者在≥8研究访问中进行了收缩压测量。SBP控制在<；50%，50%到<；75%，75%到<；100%，和100%被归类为<；140 mm Hg。多发病进展由发生的慢性疾病的数量定义，包括关节炎、哮喘、心房颤动、癌症、慢性肾脏疾病、慢性阻塞性肺疾病、冠心病、痴呆、抑郁症、糖尿病、心力衰竭、高脂血症、骨质疏松症和中风。复发事件生存分析用于计算持续SBP控制与多发病进展之间的比率比(RR)。在中位9.0年的随访期中，SBP控制者每10人年的发病率(95%CI)分别为5.2(5.1，5.4)，4.7(4.5，4.8)，4.4(4.2，4.5)和4.0(3.8，4.2)，分别为50%，50%，75%和100%。与50%就诊时SBP控制者相比，在50%就诊时SBP控制者多发病进展的调整RRS(95%CI)分别为0.90(0.86，0.95)，0.85(0.81，0.89)，0.77(0.72，0.82)。维持血压控制可能是减缓多病进展、减轻多病人群负担的有效方法。
Due to the high costs and excess mortality associated with multimorbidity, there is a need to develop approaches for delaying its progression. High blood pressure (BP) is a common chronic condition and a risk factor for many additional chronic conditions making it an ideal target for intervention. The purpose of this analysis was to determine the association between the level of sustained BP control and the progression of multimorbidity. Retrospective cohort study. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) linked to Medicare claims. 6,591 ALLHAT participants with Medicare who had systolic BP (SBP) measurements at ≥ 8 study visits. SBP control was categorized as <140 mm Hg at <50%, 50% to <75%, 75% to <100%, and 100% of visits. Multimorbidity progression was defined by the number of incident chronic conditions including arthritis, asthma, atrial fibrillation, cancer, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, dementia, depression, diabetes mellitus, heart failure, hyperlipidemia, osteoporosis, and stroke. Recurrent events survival analysis was used to calculate rate ratios (RRs) for the association of sustained SBP control with progression of multimorbidity. Rates of incident conditions per 10 person-years (95% CI) were 5.2 (5.1, 5.4), 4.7 (4.5, 4.8), 4.4 (4.2, 4.5), and 4.0 (3.8, 4.2) for participants with SBP control at <50%, 50% to <75%, 75% to <100%, and 100% of visits, respectively, over a median follow-up of 9.0 years. Compared to participants with SBP control at <50% of visits, adjusted RRs (95% CI) for multimorbidity progression were 0.90 (0.86, 0.95), 0.85 (0.81, 0.89), and 0.77 (0.72, 0.82) for those with SBP control at 50% to <75%, 75% to <100%, and 100% of visits, respectively. Sustaining BP control may be an effective approach to slow multimorbidity progression and reduce the population burden of multimorbidity.
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影响因子：
37.8
作者：
Muntner P;Carey RM;Gidding S;Jones DW;Taler SJ;Wright JT Jr;Whelton PK
通讯作者：
Whelton PK
影响因子：
2.8
作者：
Bowling, C. Barrett;Davis, Barry R.;Muntner, Paul
通讯作者：
Muntner, Paul
影响因子：
11.1
作者：
Marengoni, A.;von Strauss, E.;Fratiglioni, L.
通讯作者：
Fratiglioni, L.
影响因子：
120.7
作者：
Boyd, CM;Darer, J;Wu, AW
通讯作者：
Wu, AW
影响因子：
1.9
作者：
Ghosh, D;Lin, DY
通讯作者：
Lin, DY