Long-term exposure to elevated blood pressure and mortality from cardiovascular disease in a Japanese population: the Ibaraki Prefectural Health Study
Long-term exposure to elevated blood pressure and mortality from cardiovascular disease in a Japanese population: the Ibaraki Prefectural Health Study
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DOI：
10.1038/hr.2010.173
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发表时间：
2011-01-01
影响因子：
5.4
通讯作者：
Muto, Takashi
中科院分区：
文献类型：
--
作者：
Sasai, Hiroyuki;Sairenchi, Toshimi;Muto, Takashi
高血压(BP)已被公认为心血管疾病和死亡率的主要危险因素。然而，长期暴露于血压升高对亚洲人群死亡风险的影响尚不清楚。这项研究的目的是在日本人群中调查5年内时间平均血压水平对随后的心血管疾病死亡率的影响。共有46 484名年龄在40-79岁的成年人(男性14 771人，女性31 713人)在1993年和1998年在日本茨城县接受了健康检查，年龄在40-79岁，没有中风或心脏病病史，对他们进行了跟踪调查，直至2005年。死亡率的风险比(HR)采用Cox比例风险模型进行估计。1993年和1998年测量了与收缩压升高10 mm Hg相关的多变量HR(95%可信区间)，其平均值分别为1.11(1.05~1.16)、1.13(1.07~1.18)和1.17(1.10~1.27)。男性时均收缩压升高10 mm Hg的多变量相对危险度为1.12(1.03-1.21)，女性为1.24(1.13-1.35)。抗高血压用药亚组分析显示，持续未用药组和持续用药组时间平均收缩压的多变量HR分别为1.20(1.11~1.29)和1.17(1.04~1.32)。舒张压也得到了类似的结果。总而言之，长期暴露于血压升高与日本受试者心血管疾病死亡的额外风险密切相关，而不考虑抗高血压药物的使用。因此，无论是使用还是不使用抗高血压药物，适当的血压管理都是重要的。高血压研究(2011年)34,139144；DOI：10.1038/hr.2010.173；2010年10月7日在线发布
High blood pressure (BP) has been well established as a leading risk factor for both cardiovascular disease and mortality in general. However, the effect of long-term exposure to elevated BP on mortality risks in Asian populations remains unclear. The purpose of this study was to investigate the effects of time-averaged BP levels over 5 years on subsequent cardiovascular disease mortalities in a Japanese population. A total of 46 484 adults (14 771 men and 31 713 women) aged 40-79 years, who had no history of stroke or heart disease and who underwent health checkups in Ibaraki prefecture, Japan, in 1993 and 1998 were followed up through 2005. Hazard ratios (HRs) for mortality were estimated using a Cox proportional hazard model. Multivariate HRs (95% confidence interval) associated with a 10 mm Hg increase in systolic BP were measured in 1993 and 1998, and their averages were 1.11 (1.05-1.16), 1.13 (1.07-1.18) and 1.17 (1.10-1.27), respectively. Multivariate HRs for a 10 mm Hg increase in time-averaged systolic BP were 1.12 (1.03-1.21) in men and 1.24 (1.13-1.35) in women. The subgroup analysis of antihypertensive use showed that multivariate HRs for time-averaged systolic BP were 1.20 (1.11-1.29) in sustained non-users and 1.17 (1.04-1.32) in sustained users. Similar results were also obtained for diastolic BP. In conclusion, long-term exposure to elevated BP substantially associates with excess risk for cardiovascular disease mortality among Japanese subjects, irrespective of antihypertensive medication use. Thus, appropriate management of BP is important in both users and non-users of antihypertensive medication. Hypertension Research (2011) 34, 139-144; doi:10.1038/hr.2010.173; published online 7 October 2010