Associations Between Blood Pressure and Outcomes Among Blacks in the Jackson Heart Study.
Associations Between Blood Pressure and Outcomes Among Blacks in the Jackson Heart Study.
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DOI：
10.1161/jaha.116.003928
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发表时间：
2016-12-07
影响因子：
5.4
通讯作者：
O'Brien EC
中科院分区：
文献类型：
--
作者：
Randolph TC;Greiner MA;Egwim C;Hernandez AF;Thomas KL;Curtis LH;Muntner P;Wang W;Mentz RJ;O'Brien EC
2014年，新的高血压指南放宽了60岁及以上人群的血压目标。人们对这对黑人的影响知之甚少。使用2000年至2011年Jackson心脏研究（Jackson Heart Study）的5280名参与者的数据，我们研究了高血压是否与更高的死亡率和心力衰竭住院风险相关，以及不同年龄组的风险是否相同。Jackson心脏研究是密西西比州Jackson的一个以社区为基础的黑人队列。我们调查了基线血压与死亡率和心力衰竭住院之间的关系。我们还在死亡率模型中测试了年龄和血压之间的相互作用。基线时的中位收缩压和舒张压分别为125 mm Hg（25 - 75百分位，114-137 mm Hg）和79 mm Hg （72-86 mm Hg）。死亡患者的中位随访时间为9年，心力衰竭患者的中位随访时间为7年。多变量校正后，收缩压每升高10毫米汞柱，死亡风险（危险比1.12;95% CI, 1.06-1.17）和心力衰竭住院风险（1.07;95% CI, 1.00-1.14）增加。60岁以下的参与者收缩压每升高10毫米汞柱的死亡风险（1.26,95% CI, 1.13-1.42）高于60岁及以上的参与者（1.09,95% CI, 1.03-1.15）。随着收缩压的升高，所有年龄组的成年人都有更高的死亡风险。在2014年高血压指南的背景下，在确定黑人患者的治疗目标时应考虑这些发现。
In 2014, new hypertension guidelines liberalized blood pressure goals for persons 60 years and older. Little is known about the implications for blacks. Using data from 2000 through 2011 for 5280 participants in the Jackson Heart Study, a community‐based black cohort in Jackson, Mississippi, we examined whether higher blood pressure was associated with greater risk of mortality and heart failure hospitalization, and whether the risk was the same across age groups. We investigated associations between baseline blood pressure and both mortality and heart failure hospitalization. We also tested for interactions between age and blood pressure in the mortality model. Median systolic and diastolic blood pressures at baseline were 125 mm Hg (25th–75th percentile, 114–137 mm Hg) and 79 mm Hg (72–86 mm Hg), respectively. Median follow‐up was 9 years for mortality and 7 years for heart failure hospitalization. After multivariable adjustment, every 10 mm Hg increase in systolic blood pressure was associated with greater risks of mortality (hazard ratio, 1.12; 95% CI, 1.06–1.17) and heart failure hospitalization (1.07; 95% CI, 1.00–1.14). The mortality risk per 10 mm Hg increase in systolic blood pressure was greater in participants younger than 60 years (1.26; 95% CI, 1.13–1.42) than among participants 60 years and older (1.09; 95% CI, 1.03–1.15). Adults in all age groups were at greater risk of mortality as systolic blood pressure increased. In the context of the 2014 hypertension guidelines, these findings should be considered when determining treatment goals in black patients.