Residual lifetime risk for developing hypertension in middle-aged women and men - The Framingham Heart Study
Residual lifetime risk for developing hypertension in middle-aged women and men - The Framingham Heart Study
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DOI：
10.1001/jama.287.8.1003
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发表时间：
2002-02-27
影响因子：
120.7
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Vasan, RS;Beiser, A;Levy, D
背景发展高血压的长期风险最好通过终生风险统计来描述。高血压的终生风险和这种风险随时间的趋势是未知的。目的估计美国老年人高血压的剩余终生风险，并评估这种风险的时间趋势。设计，设置，和参与者：一项以社区为基础的前瞻性队列研究，1298名参与者来自心脏研究，年龄在55至65岁之间，基线时无高血压（1976-1998年）主要结果衡量剩余寿命风险（未调整竞争性死亡原因的终生累积发病率），定义为血压140/90 mm Hg或更高或使用抗高血压药物。结果发生高血压和1期高血压或更高的剩余终身风险在55岁和65岁的参与者中，大于或等于140/90 mm Hg（不考虑治疗）的比例均为90%。终生接受抗高血压药物治疗的概率为60%。女性的高血压风险保持不变，但在当代1976-1998年期间，男性的高血压风险比1952-1975年期间高出约60%。相比之下，在最近的一段时间内，两种性别中2期高血压或更高血压（≥ 160/100 mm Hg，不考虑治疗）的剩余终生风险显著降低（1952-1975年为35%-57%，1976-1998年为35%-44%），可能是由于对血压显著升高的个体的治疗显著增加。结论中老年人高血压的剩余终生风险为90%，这意味着巨大的公共卫生负担。虽然2期或更高血压的终生风险下降代表了一项重大成就，但应努力进行高血压的一级预防。
Context The long-term risk for developing hypertension is best described by the lifetime risk statistic. The lifetime risk for hypertension and trends in this risk over time are unknown.Objectives To estimate the residual lifetime risk for hypertension in older US adults and to evaluate temporal trends in this risk.Design, Setting, and Participants Community-based prospective cohort study of 1298 participants from the Framingham Heart Study who were aged 55 to 65 years and free of hypertension at baseline 1976-1998).Main Outcome Measures Residual lifetime risk (lifetime cumulative incidence not adjusted for competing causes of mortality) for hypertension, defined as blood pressure of 140/90 mm Hg or greater or use of anti hypertensive medications.Results The residual lifetime risks for developing hypertension and stage 1 high blood pressure or higher (greater than or equal to140/90 mm Hg regardless of treatment) were 90% in both 55- and 65-year-old participants. The lifetime probability of receiving anti hypertensive medication was 60%. The risk for hypertension remained unchanged for women, but it was approximately 60% higher for men in the contemporary 1976-1998 period compared with an earlier 1952-1975 period. In contrast, the residual lifetime risk for stage 2 high blood pressure or higher greater than or equal to160/100 mm Hg regardless of treatment) was considerably lower in both sexes in the recent period (35%-57% in 1952-1975 vs 35%-44% in 1976-1998), likely due to a marked increase in treatment of individuals with substantially elevated blood pressure.Conclusion The residual lifetime risk for hypertension for middle-aged and elderly individuals is 90%, indicating a huge public health burden. Although the decline in lifetime risk for stage 2 high blood pressure or higher represents a major achievement, efforts should be directed at the primary prevention of hypertension.