Prehypertension, diabetes, and cardiovascular disease risk in a population-based sample - The Strong Heart Study
Prehypertension, diabetes, and cardiovascular disease risk in a population-based sample - The Strong Heart Study
复制标题
DOI：
10.1161/01.hyp.0000205119.19804.08
复制
发表时间：
2006-03-01
期刊：
影响因子：
8.3
通讯作者：
Howard, BV
中科院分区：
文献类型：
--
作者：
Zhang, Y;Lee, ET;Howard, BV
关于最近定义的高血压前期类别（收缩压 120 至 139 mm Hg 或舒张压 80 至 89 mm Hg）对心血管疾病发病率影响的数据很少。尚不清楚这种关联在患有或未患有糖尿病的个体之间是否有所不同。对总共 2629 名基线检查时没有高血压和心血管疾病的强心脏研究参与者进行了为期 12 年的随访，以观察心血管疾病的发生情况。 2629 名参与者中约有 42% 患有糖尿病。我们评估了高血压前期的患病率以及与高血压前期相关的心血管疾病的风险比。糖尿病前期的高血压患病率高于非糖尿病参与者（59.4% vs 48.2%，根据年龄调整后，P < 0.001）。与血压正常的非糖尿病参与者相比，同时患有高血压前期和糖尿病的患者心血管疾病的风险比为3.70（95%置信区间：2.66，5.15），单独患有高血压前期的患者为1.80（1.28，2.54），单独患有糖尿病的患者为2.90（2.03，4.16）。糖耐量受损或空腹血糖受损也大大增加了高血压前期人群患心血管疾病的风险。有必要对更积极的干预措施进行临床研究，例如对空腹血糖受损、糖耐量受损或糖尿病的高血压前期患者进行药物控制血压治疗。
There are few data about the impact of the recently-defined category of prehypertension (systolic blood pressure 120 to 139 mm Hg or diastolic blood pressure 80 to 89 mm Hg) on cardiovascular disease incidence. It is also unknown whether this association differs between individuals with or without diabetes. A total of 2629 Strong Heart Study participants free from hypertension and cardiovascular disease at baseline examination were followed for 12 years to observe incident cardiovascular disease. Approximately 42% of the 2629 participants had diabetes. We assessed the prevalence of prehypertension and the hazard ratios of incident cardiovascular disease associated with prehypertension. Prehypertension was more prevalent in diabetic than nondiabetic participants (59.4% versus 48.2%, P < 0.001 adjusted for age). Compared with nondiabetic participants with normal blood pressure, the hazard ratios of cardiovascular disease were 3.70 (95% confidence interval: 2.66, 5.15) for those with both prehypertension and diabetes, 1.80 (1.28, 2.54) for those with prehypertension alone and 2.90 (2.03, 4.16) for those with diabetes alone. Impaired glucose tolerance or impaired fasting glucose also greatly increased the cardiovascular disease risk in prehypertensive people. Clinical investigation of more aggressive interventions, such as drug treatment for blood pressure control for prehypertensive individuals with impaired fasting glucose, impaired glucose tolerance, or diabetes is warranted.