Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices - The ohasama study
Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices - The ohasama study
复制标题
DOI：
10.1161/01.hyp.0000242285.83728.ee
复制
发表时间：
2006-11-01
期刊：
影响因子：
8.3
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Inoue, Ryusuke;Ohkubo, Takayoshi;Imai, Yutaka
我们研究了卒中与动态血压监测测定的血压（BP）指数（收缩压[SBP]、舒张压[DBP]、平均血压[MBP]和脉压[PP]）之间的关系。比较了这些指标在日本普通人群中对中风的预测能力。我们获得了1271名受试者（40%为男性）的动态血压数据，年龄bb0 = 40（平均：61）岁。在平均11年的随访中，观察到113例中风。通过Cox比例风险回归确定各血压指数升高1-SD的多因素校正相对危险度和似然比。将2个指标的Cox模型与1个指标的Cox模型进行似然比比较，PP模型的信息量明显小于其他指标（在PP模型中加入MBP、SBP、DBP时P < 0.01；在模型中加入PP时P < 0.09）。然而，在协变量中去除年龄后，PP比DBP和MBP更具信息量（将PP加入MBP或DBP模型时P < 0.0001，而SBP即使在去除年龄后也比PP更具信息量；将SBP加入PP模型时P < 0.05）。总之，PP是中风最弱的预测因子。从协变量中排除年龄增加了PP的预测能力，表明与PP相关的卒中风险反映了衰老本身的风险。
We investigated the association between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP [MBP], and pulse pressure [PP]) determined by ambulatory BP monitoring. The predictive power for stroke of these indices was compared in the general Japanese population. We obtained ambulatory BP data in 1271 subjects (40% men) aged >= 40 (mean: 61) years. During a mean follow-up of 11 years, 113 strokes were observed. The multivariate adjusted relative hazard and likelihood ratio for a 1-SD increase for each BP index was determined by Cox proportional hazard regression. Comparison of the likelihood ratio between Cox models including 2 indices and those including 1 index indicated that PP was significantly less informative than other indices (P < 0.01 when adding MBP, SBP, or DBP to the PP model; P > 0.09 when adding PP to the model including another index). However, after removing age from covariates, PP became more informative than DBP and MBP (P < 0.0001 when adding PP to the MBP or DBP model, whereas SBP was more informative than PP even after removing age; P < 0.05 when adding SBP to the PP model). In conclusion, PP was the weakest predictor of stroke. Exclusion of age from covariates increased the predictive power of PP, suggesting that the stroke risk associated with PP reflected the risk of aging per se.