Blood pressure tracking over the adult life course: patterns and correlates in the Framingham heart study.
Blood pressure tracking over the adult life course: patterns and correlates in the Framingham heart study.
复制标题
成人生活过程中的血压跟踪：弗雷明汉心脏研究中的模式和相关性。
DOI：
10.1161/hypertensionaha.112.201780
复制
发表时间：
2012-12
期刊：
影响因子：
--
通讯作者：
Vasan RS
中科院分区：
文献类型：
--
作者：
Cheng S;Xanthakis V;Sullivan LM;Vasan RS
血管危险因素对血压（BP）的影响程度尚不完全清楚。因此，我们使用多层次模型分析了21，732人在28年期间对心脏病研究参与者（平均年龄38岁，52%女性; 4，993名独特的个体）进行的连续BP测量。我们将每个血压测量值（收缩压[SBP]、舒张压[DBP]、平均动脉压[MAP]和脉压[PP]）的纵向跟踪与年龄、性别、体重指数（BMI）、吸烟、糖尿病、总/高密度脂蛋白（HDL）胆固醇比值和心率相关。在多变量校正分析中，我们观察到年龄较大、男性、BMI较大和心率较高与所有血压测量值的增加呈正相关（p<0.0001）。值得注意的是，较高的总胆固醇/HDL胆固醇比率与较高的MAP相关（p<0.01）。相反，糖尿病和吸烟与较高的PP相关（p<0.01）。我们还观察到性别的影响：与男性相比，女性PP随年龄和BMI的增加更为明显（p<0.0001）。在具有多种血管危险因素的男性和女性中，所有血压测量值均处于较高水平。综上所述，我们对一个大型社区样本的纵向观察表明，随着年龄的增长，女性的脉动负荷比男性大。我们还观察到选择的血管危险因素对BP的各个组成部分的不同影响，强调了这些措施在生命过程中的不同调节。
The extent to which select vascular risk factors differentially influence blood pressure (BP) is incompletely understood. Thus, we used multilevel modeling to analyze serial BP measurements using 21,732 person-observations obtained on Framingham Heart Study participants (mean age 38 years, 52% women; 4,993 unique individuals) over a 28-year period. We related longitudinal tracking of each BP measure (systolic BP [SBP], diastolic BP [DBP], mean arterial pressure [MAP], and pulse pressure [PP]) to age, sex, body mass index (BMI), smoking, diabetes, total/high-density lipoprotein (HDL) cholesterol ratio, and heart rate. In multivariable-adjusted analyses, we observed that older age, male sex, greater BMI, and higher heart rate were positively associated with increase in all BP measures (p<0.0001). Notably, higher total/HDL cholesterol ratio was associated with greater MAP (p<0.01). Conversely, diabetes and smoking were associated with higher PP (p<0.01). We also observed effect modification by sex: the increase in PP with age and BMI was more pronounced in women compared to men (p<0.0001). All BP measures tracked at higher levels in both men and women with multiple vascular risk factors. Taken together, our longitudinal observations of a large community-based sample demonstrate a greater pulsatile load in women than men with increasing age. We also observed a differential impact of select vascular risk factors on the individual components of BP, underscoring distinct regulation of these measures over the life course.