Blood pressure control and risk of stroke -: A population-based prospective cohort study
Blood pressure control and risk of stroke -: A population-based prospective cohort study
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DOI：
10.1161/01.str.0000158925.12740.87
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发表时间：
2005-04-01
期刊：
影响因子：
8.3
通讯作者：
Janzon, L
中科院分区：
文献类型：
--
作者：
Li, CR;Engström, G;Janzon, L
背景和目的-充分控制血压（BP）是预防卒中的基石。本研究探讨了中风的风险有关的血压控制的质量，在人口为基础的队列和是否控制高血压的背景特征patients. Methods，共27 936例（10 953名男性和16 983名女性），45至73岁，生活在马尔莫，瑞典参加了这项研究。卒中发生率平均随访6年。控制血压定义为血压= 140/90 mm Hg），23%的患者接受了治疗。在接受治疗的高血压患者中，88.2%的血压水平>= 140/90 mm Hg，49.5%的血压水平>= 160/100 mm Hg。在随访期间，接受治疗的高血压受试者中发生了137例卒中。在血压控制良好的高血压受试者中，卒中的粗发病率为289/100 000人年，在血压≥ 140/90 mm Hg的高血压治疗受试者中，卒中的粗发病率为705/100 000人年。据估计，在接受高血压治疗的受试者中，约45%的卒中可能归因于血压不受控制。在接受治疗的高血压患者中，中风的风险随着年龄的增长、吸烟、舒张压水平高和糖尿病而显著增加。在未经治疗的高血压受试者（n = 12 819），中风的发病率为363/100 000 person-year.Conclusion-Uncontrolled BP是高血压药物治疗的患者中非常普遍。该组中超过90%的卒中发生在血压不受控制的患者中。适当的高血压控制可以预防相当一部分接受治疗的高血压患者发生首次卒中。
Background and Purpose-Adequate control of blood pressure (BP) is a cornerstone in stroke prevention. This study explored the risk of stroke in relation to the quality of BP control in a population-based cohort and whether control of hypertension was related to background characteristics of patients.Methods-A total of 27 936 subjects ( 10 953 men and 16 983 women), 45 to 73 years old, living in Malmo, Sweden participated in the study. Incidence of stroke was followed-up for a mean period of 6 years. Controlled BP was defined as BP = 140/90 mm Hg) and 23% of them received treatment. Among treated hypertensives, 88.2% had BP levels >= 140/90 mm Hg and 49.5% had BP levels >= 160/100 mm Hg. During the follow-up, 137 strokes occurred among treated hypertensive subjects. The crude incidence of stroke was 289/100 000 person-year in controlled hypertensive subjects and 705/100 000 person-year in treated hypertensive subjects with BP >= 140/90 mm Hg. It was estimated that approximate to 45% of all strokes among subjects with treatment for hypertension might be attributed to uncontrolled BP. In treated hypertensives, the risk of stroke increased significantly with advancing age, current smoking, high level of diastolic BP, and diabetes. In hypertensive subjects without treatment (n = 12 819), incidence of stroke was 363/100 000 person-year.Conclusion-Uncontrolled BP is highly prevalent in patients with pharmacological treatment for hypertension. More than 90% of stroke in this group occurred in those with uncontrolled BP. Adequate hypertension control may prevent a substantial proportion of first-ever stroke among treated hypertensives.