Visit-to-visit variability in blood pressure and the risk of open-angle glaucoma in individuals without systemic hypertension: a nationwide population-based cohort study.
Visit-to-visit variability in blood pressure and the risk of open-angle glaucoma in individuals without systemic hypertension: a nationwide population-based cohort study.
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血压的访问性变异性和无系统性高血压患者的开角性青光眼的风险：一项全国范围内的基于人群的队列研究。
DOI：
10.3389/fmed.2023.1300778
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发表时间：
2023
影响因子：
3.9
通讯作者：
Lee, Hun
中科院分区：
文献类型：
--
作者：
Lee, Sang Yeop;Lee, Ji Sung;Kim, Jae Yong;Tchah, Hungwon;Lee, Hun
我们的目的是使用基于人群的回顾性队列研究设计，评估访视间血压（BP）变异性对无全身性高血压个体的开角型青光眼（OAG）风险的影响。韩国国民健康保险服务-国民健康筛查队列数据库在2002年至2015年期间收集了209，226人的数据，用于分析140，910名合格参与者的数据。平均随访时间为8.3年。使用标准差（SD）、变异系数（CV）和与平均值无关的变异性（Vim）评估访视间BP变异性。根据血压变异性四分位数将参与者分为四组。我们通过比较第一至第三四分位数的BP变异组与第四四分位数组的参与者来验证BP变异的影响。考克斯比例风险模型用于确定新诊断OAG病例中BP变异性的风险比（HR）。此外，我们使用基线特征进行了亚组分析。在多变量分析中，BP变异性并没有显著增加OAG发生的风险。然而，亚组分析显示年龄和收缩压变异性在OAG的发展中具有显著的相互作用（CV：p = 0.008; SD：p = 0.007）。对于年龄<60岁的受试者，随着收缩压变异性的增加，OAG发生的风险显著增加（CV：HR，1.18; 95%置信区间[CI]，1.00-1.39; p = 0.049）。我们使用SD和Vim作为收缩压变异性的参数观察到类似的趋势。在年龄小于60岁且无全身性高血压的受试者中，较高的访视间收缩压变异性与OAG发生风险增加相关。这些结果表明，BP变异性可以是评估OAG风险的重要因素，特别是在相对年轻的无全身性高血压的人群中。
We aimed to evaluate the effect of visit-to-visit variability in blood pressure (BP) on the risk of open-angle glaucoma (OAG) in individuals without systemic hypertension using a population-based retrospective cohort study design. The Korean National Health Insurance Service-National Health Screening Cohort database, which collected data of 209,226 individuals between 2002 and 2015, was used to analyze the data of 140,910 eligible participants. The mean follow-up duration was 8.3 years. Visit-to-visit BP variability was assessed using standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM). Participants were categorized into four groups according to BP variability quartiles. We verified the effect of BP variability by comparing participants of the first to third quartiles of BP variability groups with those belonging to the fourth quartile group. A Cox proportional hazards model was used to determine the hazard ratio (HR) of BP variability in cases of newly diagnosed OAG. Moreover, we conducted subgroup analyses using baseline characteristics. In the multivariable analyses, BP variability did not significantly increase the risk of OAG development. However, subgroup analyses revealed significant interactions between age and systolic BP variability in the development of OAG (CV: p = 0.008; SD: p = 0.007). For participants aged <60 years, the risk of OAG development significantly increased with high systolic BP variability (CV: HR, 1.18; 95% confidence interval [CI], 1.00–1.39; p = 0.049). We observed a similar trend using the SD and VIM as the parameters for systolic BP variability. Higher visit-to-visit systolic BP variability was associated with an increased risk of OAG development in participants younger than 60 years of age without systemic hypertension. These results suggest that BP variability can be the considerable factor when assessing the risk of OAG, especially in relatively young people without systemic hypertension.
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影响因子：
4.6
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Park CK
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