Sex differences in cardiovascular outcomes in patients with incident hypertension.
Sex differences in cardiovascular outcomes in patients with incident hypertension.
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DOI：
10.1097/hjh.0b013e32835bdc44
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发表时间：
2013-02
影响因子：
4.9
通讯作者：
Magid DJ
中科院分区：
文献类型：
--
作者：
Daugherty SL;Masoudi FA;Zeng C;Ho PM;Margolis KL;O'Connor PJ;Go AS;Magid DJ
高血压的初始诊断时间是评估后续不良心血管结局风险的一个机会。新发现的高血压患者在多大程度上具有相似的不良心血管事件风险，包括慢性肾脏疾病，目前尚不清楚。在心血管研究网络（CVRN）高血压登记处登记的2001-2006年高血压事件的男女患者中，我们比较了包括全因死亡在内的事件事件；因心肌梗死（MI）、心力衰竭（HF）或中风住院；和慢性肾脏疾病（CKD）的发展根据患者人口统计学和临床特征调整的多变量模型。在177,521例高血压患者中，55%为女性。与男性相比，女性年龄更大，更可能是白人，并且在基线时患有更多肾脏疾病。在调整后的中位随访3.2年（IQR 1.6-4.8）中，与男性相比，女性因心衰住院的可能性相同（HR 0.90, 95% CI 0.76-1.07），因任何原因死亡（HR 0.85, 95% CI 0.80-0.90）或因心肌梗死住院（HR 0.44, 95% CI 0.39-0.50）或中风住院（HR 0.68, 95% CI 0.60-0.77）的可能性显著低于男性。女性患慢性肾脏疾病的可能性明显高于男性（9.60% vs. 7.15%；调整后HR 1.17, 95% CI 1.12-1.22）。在发生高血压的队列中，与男性相比，女性更容易发生慢性肾脏疾病，而发生其他心血管疾病的可能性更小。未来的研究应该调查这些性别差异的潜在原因。
The time of initial hypertension diagnosis represents an opportunity to assess subsequent risk of adverse cardiovascular outcomes. The extent to which women and men with newly identified hypertension are at similar risk for adverse cardiovascular events, including chronic kidney disease, is not well known. Among women and men with incident hypertension from 2001–2006 enrolled in the Cardiovascular Research Network (CVRN) Hypertension Registry, we compared incident events including all-cause death; hospitalization for myocardial infarction (MI), heart failure (HF), or stroke; and the development of chronic kidney disease (CKD). Multivariable models adjusted for patient demographic and clinical characteristics. Among 177,521 patients with incident hypertension, 55% were women. Compared to men, women were older, more likely white and had more kidney disease at baseline. Over median 3.2 years (IQR 1.6–4.8) of follow-up, after adjustment, women were equally likely to be hospitalized for HF (HR 0.90, 95% CI 0.76–1.07) and were significantly less likely to die of any cause (HR 0.85, 95% CI 0.80–0.90) or be hospitalized for MI (HR 0.44, 95% CI 0.39–0.50) or stroke (HR 0.68, 95% CI 0.60–0.77) compared to men. Women were significantly more likely to develop chronic kidney disease (9.60% vs. 7.15%; adjusted HR 1.17, 95% CI 1.12–1.22) than men. In this cohort with incident hypertension, women were more likely to develop chronic kidney disease and less likely to develop other cardiovascular outcomes compared to men. Future studies should investigate the potential reasons for these gender differences.