Prognostic significance of blood pressure and heart rate variabilities - The Ohasama study
Prognostic significance of blood pressure and heart rate variabilities - The Ohasama study
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DOI：
10.1161/01.hyp.36.5.901
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发表时间：
2000-11-01
期刊：
影响因子：
8.3
通讯作者：
Imai, Y
中科院分区：
文献类型：
--
作者：
Kikuya, M;Hozawa, A;Imai, Y
为了研究心血管死亡率与血压和心率的短期变异性之间的关系，我们从1987年开始在日本的Ohasama进行了一项动态血压监测的长期前瞻性研究。我们获得了1542名大于或等于40岁的受试者的动态血压和心率。通过动态监测每30分钟测量一次血压和心率变异性的标准差。在随访期间有67例心血管死亡（平均8.5年）。Cox比例风险模型对可能的混杂因素进行了调整，结果显示心血管死亡率显著增加，日间收缩动态血压变异性增加。在白天舒张压和夜间动态血压中也观察到类似的趋势。随着白天心率变异性的降低，心血管死亡率呈线性增加。白天收缩动态血压变异性大于第三个五分位数且白天心率变异性低于平均sd的受试者心血管死亡风险极高。通过动态血压监测每30分钟获得的血压和心率变异性是普通人群心血管死亡率的独立预测因子。
To investigate the association between cardiovascular mortality and short-term variabilities in blood pressure and heart rate, we performed a long-term prospective study of ambulatory blood pressure monitoring in Ohasama, Japan, starting in 1987. We obtained ambulatory blood pressure and heart rate in 1542 subjects greater than or equal to 40 years of age. Blood pressure and heart rate variabilities were estimated as a standard deviation measured every 30 minutes by ambulatory monitoring. There were 67 cardiovascular deaths during the follow-up period (mean=8.5 years). The Cox proportional hazards model, adjusted for possible confounding factors, demonstrated a significant increase in cardiovascular mortality, with an increase in daytime systolic ambulatory blood pressure variability. A similar trend was observed in daytime diastolic and nighttime ambulatory blood pressures. Cardiovascular mortality rate increased linearly, with a decrease in daytime heart rate variability. Subjects in whom the daytime systolic ambulatory blood pressure variability was larger than third quintile and the daytime heart rate variability was lower than the mean-SD were at extremely high risk of cardiovascular mortality. The blood pressure and heart rate variabilities obtained every 30 minutes by ambulatory blood pressure monitoring were independent predictors for cardiovascular mortality in the general population.