The effects of control of systolic and diastolic hypertension on cardiovascular and all-cause mortality in a community-based population cohort
The effects of control of systolic and diastolic hypertension on cardiovascular and all-cause mortality in a community-based population cohort
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DOI：
10.1038/jhh.2013.22
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发表时间：
2013-11-01
影响因子：
2.7
通讯作者：
Tuomilehto, J.
中科院分区：
文献类型：
--
作者：
Barengo, N. C.;Antikainen, R.;Tuomilehto, J.
本研究（随访26 113人）的目的是通过控制收缩压（SBP）和舒张压（DBP）来探讨高血压患者心血管疾病（CVD）风险和全因死亡率的差异。有冠心病、心力衰竭、癌症病史或基线数据不完整的人（n = 1113）被排除在研究之外。参与者根据他们的血压状况被分为六组。与血压正常者相比，收缩压和舒张压得到控制的高血压患者的全因死亡率没有增加。在接受降压药治疗且仅控制舒张压的患者中，全因死亡率增加1.48倍（95%可信区间（CI） 1.09-2.01），而在接受降压药治疗且仅控制收缩压的患者中，全因死亡率增加1.45倍（95% CI 1.04-2.02）。收缩压和舒张压控制的患者与血压正常者相比，心血管疾病死亡率的风险没有增加。单用收缩压、单用舒张压或收缩压和舒张压均不受控制的高血压患者的CVD死亡风险有统计学意义。我们的研究表明，单独的收缩压和舒张压不受控制是全因死亡和心血管疾病死亡的危险因素。
The objective of this study (follow-up of 26 113 people) was to investigate differences in the risk of cardiovascular disease (CVD) and all-cause mortality among hypertensive people according to the control of systolic blood pressure (SBP) and diastolic blood pressure (DBP). People with a history of coronary heart disease, heart failure, cancer or incomplete data at baseline (n = 1113) were excluded from the study. The participants were classified into six groups according to their blood pressure status. Treated hypertensive individuals with controlled SBP and DBP did not experience an increase in all-cause mortality compared with normotensive people. The increase in all-cause mortality was 1.48-fold (95% confidence interval (CI) 1.09-2.01) among those who were treated with antihypertensive drugs and had only their DBP controlled and 1.45-fold (95% CI 1.04-2.02) among those who were treated and had only their SBP controlled. Treated patients with both SBP and DBP controlled did not have an increased risk of CVD mortality when compared with normotensive people. The risk of CVD mortality was statistically significantly higher in treated hypertensive people with SBP alone, DBP alone or both SBP and DBP uncontrolled. Our study indicates that uncontrolled SBP alone and DBP alone are risk factors of all-cause and CVD mortality.