Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men - The Chicago Heart Association Detection Project in Industry
Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men - The Chicago Heart Association Detection Project in Industry
复制标题
DOI：
10.1001/archinte.161.12.1501
复制
发表时间：
2001-06-25
影响因子：
--
通讯作者：
Greenland, P
中科院分区：
文献类型：
--
作者：
Miura, K;Daviglus, ML;Greenland, P
背景：关于年轻人血压（BP）和长期死亡率的数据有限。此外，筛查和高血压治疗指南主要基于中年和老年人群的发现。本研究评估的关系，血压测量的年轻成年男子长期死亡率，由于冠心病（CHD），心血管疾病（CVD），和所有causes.Methods：这个队列从芝加哥心脏协会检测项目在工业包括10 874名男子年龄在18至39岁的基线（1967年至1973年），不接受抗高血压药物，没有CHD或糖尿病。基线血压与25年冠心病、心血管疾病和全因死亡率的关系进行了评估。结果：校正后的收缩压与冠心病死亡率的关系是连续的和分级的。收缩压（15 mm Hg）和舒张压（10 mm Hg）升高1 SD的多变量校正CHD风险比（HR）分别为1.26（95%置信区间[CI]，1.11-1.44）和1.17（95% CI，1.01-1.35）。与全国高血压预防、检测、评估和治疗联合委员会第六次报告血压正常阶层的比较（和最低的死亡率），具有正常高血压和1期高血压的大分层的25年绝对死亡风险分别为63/1000和72/1000，绝对超额风险分别为10/1000和20/1000，分别占59.8%的所有多余的冠心病，心血管疾病和全因死亡率，并估计有预期寿命缩短2.2和4.1年，分别。结论：在年轻的成年男子，血压高于正常显着相关的长期死亡率增加，由于冠心病，心血管疾病，和所有原因。从青年期开始，应在人群范围内进行一级预防、早期发现和控制高血压。
Background: Data are limited on blood pressure (BP) in young adults and long-term mortality. Moreover, screening and hypertension treatment guidelines have been based mainly on findings for middle-aged and older populations. This study assesses relationships of BP measured in young adult men to long-term mortality due to coronary heart disease (CHD), cardiovascular diseases (CVD), and all causes.Methods: This cohort from the Chicago Heart Association Detection Project in Industry included 10 874 men aged 18 to 39 years at baseline (1967-1973), not receiving antihypertensive drugs, and without CHD or diabetes. Relationship of baseline BP to 25-year CHD, CVD, and all-cause mortality was assessed.Results: Age-adjusted association of systolic BP to CHD mortality was continuous and graded. Multivariate-adjusted CHD hazard ratios (HRs) for 1 SD higher systolic BP (15 mm Hg) and diastolic BP (10 mm Hg) were 1.26 (95% confidence interval [CI], 1.11-1.44) and 1.17 (95% CI, 1.01-1.35), respectively. Compared with the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure stratum with normal BP (and lowest mortality rates), the large strata with high-normal BP and stage 1 hypertension had 25-year absolute risks for death of 63 and 72 per 1000, respectively, and absolute excess risks of 10 and 20 per 1000, respectively; accounted for 59.8% of all excess CHD, CVD, and all-cause mortality; and were estimated to have life expectancy shortened by 2.2 and 4.1 years, respectively.Conclusions: In young adult men, BP above normal was significantly related to increased long-term mortality due to CHD, CVD, and all causes. Population-wide primary prevention, early detection, and control of higher BP are indicated from young adulthood on.