IS HYPERTENSION MORE BENIGN WHEN ASSOCIATED WITH OBESITY
IS HYPERTENSION MORE BENIGN WHEN ASSOCIATED WITH OBESITY
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DOI：
10.1161/01.cir.72.1.53
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发表时间：
1985-01-01
期刊：
影响因子：
37.8
通讯作者：
KHAW, KT
中科院分区：
文献类型：
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作者：
BARRETTCONNOR, E;KHAW, KT
为了确定肥胖对高血压患者预后的影响，我们将1727名50-79岁的男性按基线体重指数(< 27和。27 kg/m2)和收缩压（< 160和.gtoreq）。160mmhg)。经过9年的随访，年龄调整的全因、心血管和缺血性心脏病死亡率在非肥胖高血压受试者中最高。收缩压为160毫米汞柱或更高的相对死亡风险仅在非肥胖组显著增加，缺血性心脏病的相对风险在肥胖和非肥胖组之间差异最大。在单独排除有心脏病、糖尿病、目前使用降压药物和吸烟史的患者以及基线检查后2年内死亡的患者后，结果一致。当使用Cox模型评估年龄、血浆胆固醇水平、吸烟、使用降压药以及个人心脏病或糖尿病史等危险因素的独立影响时，收缩压仅在非肥胖受试者中是全因、心血管和缺血性心脏病死亡的重要独立预测因子。虽然不能排除肥胖患者血压升高的不利影响，但较瘦的高血压患者的预后比超重患者差。
To determine the effect of obesity on prognosis in hypertensive subjects, a population of 1727 men 50-79 yr of age was dichotomized by baseline body mass index (< 27 and .gtoreq. 27 kg/m2) and systolic blood pressure (< 160 and .gtoreq. 160 mm Hg). After 9 yr of follow-up, age-adjusted all-cause, cardiovascular and ischemic heart disease mortality rates were highest in the nonobese hypertensive subjects. The relative risk for mortality associated with a systolic blood pressure of 160 mm Hg or higher was significantly increased only in the nonobese group, with the largest difference in relative risk between obese and nonobese for ischemic heart disease. Results were consistent after separately excluding those with a history of heart disease, diabetes, current use of antihypertensive medication, and cigarette smoking, and those who died within 2 yr of the baseline examination. When the independent effect of risk factors, including age, plasma cholesterol level, cigarette smoking, use of antihypertensive medication, and personal history of heart disease or diabetes was assessed with the Cox model, systolic blood pressure was a significant independent predictor of all-cause, cardiovascular, and ischemic heart disease death only in the nonobese subjects. While an adverse effect of raised blood pressure in the obese is not excluded, the prognosis is poorer in leaner hypertensive patients than in those who are overweight.