Predictive Value for Mortality of the Double Product at Rest Obtained by Home Blood Pressure Measurement: The Ohasama Study
Predictive Value for Mortality of the Double Product at Rest Obtained by Home Blood Pressure Measurement: The Ohasama Study
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DOI：
10.1038/ajh.2012.3
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发表时间：
2012-05-01
影响因子：
3.2
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Inoue, Ryusuke;Ohkubo, Takayoshi;Imai, Yutaka
背景：为了阐明基于家庭血压(HBP)测量的静息双倍乘积(DP)(收缩压(SBP)和脉率(PR)的乘积)是否具有预测死亡率的价值。方法获得了2583名参与者的数据，这些参与者来自日本普通人群(40%的男性)，年龄=35岁(平均59岁)，没有心血管疾病(CVD)病史。通过COX比例风险回归分析确定DP升高1000 mm Hgx次/min的预后意义。结果在平均12.0年的随访期中，共发生454例死亡，153例心血管死亡(85例心脏病，68例中风)，301例非心血管死亡。DP与总死亡率、心血管疾病死亡率、心脏病死亡率、卒中死亡率和非心血管死亡率呈显著正相关。LR检验表明，与SBP相比，DP与总死亡率、心脏病死亡率和非心血管疾病死亡率的相关性更强。同样，DP与总死亡率、心血管疾病死亡和卒中死亡的相关性比PR更强。结论家庭DP与死亡率显著相关，LR检验表明DP与死亡率之间的关联比死亡率与SBP或PR之间的关联更强。这些发现是初步的，还需要进一步的研究来证实DP在风险分层中的有效性。
BACKGROUNDTo clarify whether the double product (DP) (product of systolic blood pressure (SBP) and pulse rate (PR)) at rest based on home blood pressure (HBP) measurement has prognostic value for mortality.METHODSHBP data of 2,583 participants from a Japanese general population (40% men) >= 35 years of age (mean, 59 years) without a history of cardiovascular disease (CVD) were obtained. The prognostic significance for a 1,000 mm Hg x beats/min elevation in the DP was determined by Cox proportional hazard regression analysis. The association between mortality and the DP was compared to that between mortality and the SBP or the PR using the likelihood ratio (LR) test.RESULTSDuring a mean follow-up of 12.0 years, 454 total deaths, 153 CVD deaths (85 cardiac diseases, 68 strokes), and 301 non-CVD deaths occurred. The DP was positively and significantly associated with total, CVD, cardiac, stroke, and non-CVD mortality. The LR test showed that the DP was more strongly associated with total mortality, mortality from cardiac disease, and non-CVD than SBP. Similarly, the DP was more strongly associated with total death, CVD death, and death from stroke than PR.CONCLUSIONSThe home DP was significantly associated with mortality, and the LR test indicated that the association between the DP and mortality would be stronger than that between mortality and SBP or PR. These findings are preliminary, and further study is needed to confirm the usefulness of the DP in risk stratification.