Systolic blood pressure and incident heart failure in the elderly. The Cardiovascular Health Study and the Health, Ageing and Body Composition Study.
Systolic blood pressure and incident heart failure in the elderly. The Cardiovascular Health Study and the Health, Ageing and Body Composition Study.
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DOI：
10.1136/hrt.2011.225482
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发表时间：
2011-08
期刊：
影响因子：
--
通讯作者：
Psaty BM
中科院分区：
文献类型：
--
作者：
Butler J;Kalogeropoulos AP;Georgiopoulou VV;Bibbins-Domingo K;Najjar SS;Sutton-Tyrrell KC;Harris TB;Kritchevsky SB;Lloyd-Jones DM;Newman AB;Psaty BM
老年人收缩压（SBP）与心力衰竭（HF）风险之间关联的确切形式尚未完全确定，特别是对于未接受抗高血压药物的个体。我们的目的是研究老年人收缩压和心力衰竭风险之间的关联。利用 NIH 赞助的两项队列研究的 10 年随访数据，对心力衰竭风险进行竞争风险比例风险建模；心血管健康研究（启动：1989-90 和 1992-93）和健康 ABC 研究（启动：1997-98）。以社区为基础的群体。 4408 名参与者（年龄为 72.8 [4.9] 岁；53.1% 为女性，81.7% 为白人；18.3% 为黑人），没有普遍存在心力衰竭且基线时未接受抗高血压药物治疗。心力衰竭事件，定义为首次因心力衰竭住院治疗。 10 年来，493 名（11.1%）参与者出现心力衰竭。高血压前期 (120-139 mmHg)、1 期 (140-159 mmHg) 和 2 期 (≥160 mmHg) 高血压与心力衰竭风险升高相关；在控制临床特征的竞争风险模型中，风险比与最佳收缩压（<120 mmHg）分别为 1.63（95% CI，1.23-2.16；P=0.001）、2.21（95% CI，1.65-2.96；P<0.001）和 2.60（95% CI，1.85-364；P=0.001）。 P<0.001），分别。总共 493 起心力衰竭事件中，有 255 起 (51.7%) 发生在基线 SBP <140 mm Hg 的参与者中。女性收缩压升高与男性心力衰竭风险较高相关；没有观察到种族-SBP 相互作用。在连续 SBP 分析中，心力衰竭风险与 SBP 呈持续正相关，男性 SBP 水平低至 113 mmHg，女性低至 112 mmHg。对于老年人，当 SBP 水平低至 <115 mmHg 时，SBP 与心力衰竭风险之间存在持续正相关；超过一半的心力衰竭事件发生在 SBP <140 mmHg 的个体中。
The exact form of the association between systolic blood pressure (SBP) and heart failure (HF) risk in the elderly remains incompletely defined, especially in individuals not receiving antihypertensive medications. Our aim was to examine the association between SBP and HF risk in the elderly. Competing-risks proportional hazards modeling of incident HF risk, utilizing 10-year follow-up data from two NIH-sponsored cohort studies; the Cardiovascular Health Study (inception: 1989-90 and 1992-93) and the Health ABC Study (inception: 1997-98). Community-based cohorts. 4408 participants (age, 72.8 [4.9] years; 53.1% women, 81.7% white; 18.3% black) without prevalent HF and not receiving antihypertensive medications at baseline. Incident HF, defined as first adjudicated hospitalisation for HF. Over 10 years, 493 (11.1%) participants developed HF. Prehypertension (120-139 mmHg), stage 1 (140-159 mmHg), and stage 2 (≥160 mmHg) hypertension were associated with escalating HF risk; hazard ratios vs. optimal SBP (<120 mmHg) in competing-risks models controlling for clinical characteristics were 1.63 (95% CI, 1.23-2.16; P=0.001), 2.21 (95% CI, 1.65-2.96; P<0.001), and 2.60 (95% CI, 1.85-364; P<0.001), respectively. Overall 255 of 493 (51.7%) HF events occurred in participants with SBP <140 mm Hg at baseline. Increasing SBP was associated with higher HF risk in women than men; no race-SBP interaction was observed. In analyses with continuous SBP, HF risk had a continuous positive association with SBP to levels as low as 113 mmHg in men and 112 mmHg in women. There is a continuous positive association between SBP and HF risk in the elderly for levels of SBP as low as <115 mmHg; over half of incident HF events occur in individuals with SBP <140 mmHg.
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影响因子：
9.7
作者：
Kalogeropoulos, Andreas;Psaty, Bruce M.;Butler, Javed
通讯作者：
Butler, Javed
影响因子：
37.8
作者：
Bibbins-Domingo, K;Lin, F;Shlipak, MG
通讯作者：
Shlipak, MG
影响因子：
--
作者：
Kalogeropoulos, Andreas;Georgiopoulou, Vasiliki;Kritchevsky, Stephen B.;Psaty, Bruce M.;Smith, Nicholas L.;Newman, Anne B.;Rodondi, Nicolas;Satterfield, Suzanne;Bauer, Douglas C.;Bibbins-Domingo, Kirsten;Smith, Andrew L.;Wilson, Peter W. F.;Vasan, Ramachandran S.;Harris, Tamara B.;Butler, Javed
通讯作者：
Butler, Javed
影响因子：
2.7
作者：
Barnard, J;Rubin, DB
通讯作者：
Rubin, DB
影响因子：
5.9
作者：
Dunlay, Shannon M.;Weston, Susan A.;Roger, Veronique L.
通讯作者：
Roger, Veronique L.