Predictors of new-onset diastolic and systolic hypertension - The Framingham heart study
Predictors of new-onset diastolic and systolic hypertension - The Framingham heart study
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DOI：
10.1161/01.cir.0000157159.39889.ec
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发表时间：
2005-03-08
期刊：
影响因子：
37.8
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Franklin, SS;Pio, JR;Levy, D
背景-导致单纯舒张期（IDH）、收缩期舒张期（SDH）和单纯收缩期（ISH）高血压发生的差异因素知之甚少。我们研究了血压（BP）和临床危险因素的关系，新的发病的3种形式的hypertension.Methods和结果-参与者在心脏研究的心脏Frachial包括，如果他们经历了2个两年一次的检查之间的1953年和1957年，是免费的抗高血压治疗和心血管疾病。与最佳血压（SBP < 120和DBP < 80 mm Hg）相比，在随后的10年中，发生新发IDH的校正风险比（HR）为正常血压2.75，正常高血压3.29（均P < 0.0001），SDH 1.31（P = 0.40），ISH 0.61（P = 0.36）。正常血压组、正常高值血压组、ISH组和IDH组新发SDH的HR分别为3.32、7.96、7.10和23.12（均P < 0.0001）。发展中ISH的HR分别为正常血压组3.26（P < 0.0001）、正常高值组4.82（P < 0.0001）、IDH组1.39（P = 0.24）、SDH组1.69（P < 0.01）。随访期间体重指数（BMI）增加可预测新发IDH和SDH。IDH的其他预测因素是年龄较小、男性和基线BMI。ISH的预测因素包括年龄较大，女性，并增加BMI在follow-up.Conclusion -鉴于增加基线BMI和体重增加的倾向，以预测新发IDH和IDH的高概率过渡到SDH，它很可能是IDH是不是一个良性的条件。ISH更常见于正常血压和正常高血压，而不是“耗尽”舒张期高血压。
Background - Factors leading differentially to the development of isolated diastolic (IDH), systolic-diastolic (SDH), and isolated systolic ( ISH) hypertension are poorly understood. We examined the relations of blood pressure ( BP) and clinical risk factors to the new onset of the 3 forms of hypertension.Methods and Results - Participants in the Framingham Heart Study were included if they had undergone 2 biennial examinations between 1953 and 1957 and were free of antihypertensive therapy and cardiovascular disease. Compared with optimal BP ( SBP < 120 and DBP < 80 mm Hg), the adjusted hazard ratios (HRs) for developing new-onset IDH over the ensuing 10 years were 2.75 for normal BP, 3.29 for high-normal BP ( both P < 0.0001), 1.31 ( P = 0.40) for SDH, and 0.61 ( P = 0.36) for ISH. The HRs of developing new-onset SDH were 3.32, 7.96, 7.10, and 23.12 for the normal BP, high-normal BP, ISH, and IDH groups, respectively ( all P < 0.0001). The HRs of developing ISH were 3.26 for normal and 4.82 for high-normal BP ( both P < 0.0001), 1.39 ( P = 0.24) for IDH, and 1.69 ( P < 0.01) for SDH. Increased body mass index (BMI) during follow-up predicted new-onset IDH and SDH. Other predictors of IDH were younger age, male sex, and BMI at baseline. Predictors of ISH included older age, female sex, and increased BMI during follow-up.Conclusion - Given the propensity for increased baseline BMI and weight gain to predict new-onset IDH and the high probability of IDH to transition to SDH, it is likely that IDH is not a benign condition. ISH arises more commonly from normal and high-normal BP than from "burned-out" diastolic hypertension.