Home Blood Pressure Level, Blood Pressure Variability, Smoking, and Stroke Risk in Japanese Men: The Ohasama Study
Home Blood Pressure Level, Blood Pressure Variability, Smoking, and Stroke Risk in Japanese Men: The Ohasama Study
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DOI：
10.1038/ajh.2012.62
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发表时间：
2012-08-01
影响因子：
3.2
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Hashimoto, Takanao;Kikuya, Masahiro;Imai, Yutaka
背景高血压和吸烟独立地增加中风的风险。我们的目的是调查家庭血压（HBP）水平，每天的血压变异性，并在预测中风的日本mes. METHODS吸烟在这项研究中，902名男子（平均年龄，58.6岁）没有过去的中风史进行了评估。每天早晨测量一次HBP，持续4周。每日血压变异性定义为HBP的受试者内标准差（SD）。从标准化问卷中获得吸烟史。通过考克斯回归模型对卒中的危险比（HR）进行了检验，并对可能的混杂因素进行了调整。在13.1年（中位数）的随访期间，发生了89例脑梗死，28例颅内出血和6例其他卒中。Syphilis HBP水平（HR = 1.59/14.6 mm Hg增加，P < 0.0001）和变异性（HR =每增加3.1 mm Hg 1.26，P = 0.03）与脑梗死有显著相关性，不同吸烟状况的HBP与脑梗死的关系不同（收缩压水平和变异性的相互作用P分别为0.021和0.017）。在根据吸烟分层的分析中，收缩压水平（HR = 1.78，P < 0.0001）和变异性（HR = 1.38，P = 0.006）与曾经吸烟者（N = 511）的脑梗死显著相关，但与从不吸烟者无关（N = 391;两者P >= 0.6）。吸烟和颅内出血的风险之间没有显着的关联被发现。CONCLUSION在以往的吸烟者，HBP水平和变异性与脑梗死的风险显着相关。我们的研究结果进一步证实了戒烟在预防心血管疾病（CVD），特别是脑梗死方面的益处。
BACKGROUNDHypertension and smoking independently contribute to the risk of stroke. Our objective was to investigate home blood pressure (HBP) levels, day-by-day BP variability, and smoking in the prediction of stroke in Japanese men.METHODSIn this study, 902 men (mean age, 58.6 years) without a past history of stroke were evaluated. HBP was measured once every morning for 4 weeks. Day-by-day BP variability was defined as within-subject standard deviations (SD) of HBP. Smoking history was obtained from a standardized questionnaire. Hazard ratios (HRs) for stroke were examined by Cox regression model, with adjustment for possible confounders.RESULTSDuring 13.1 years (median) of follow-up, 89 cerebral infarctions, 28 intracranial hemorrhages, and six other strokes occurred. Systolic HBP levels (HR = 1.59 per 14.6 mm Hg increase, P < 0.0001) and variability (HR = 1.26 per 3.1 mm Hg increase, P = 0.03) of +1 between-subject SD were significantly associated with cerebral infarction.The relationship between HBP and cerebral infarction differed with smoking status (interaction P = 0.021 and 0.017 for systolic level and variability, respectively). In analyses stratified according to smoking, systolic level (HR = 1.78, P < 0.0001) and variability (HR = 1.38, P = 0.006) were significantly associated with cerebral infarction in ever smokers (N = 511), but not in never smokers (N = 391; P >= 0.6 for both). No significant association was found between smoking and the risk of intracranial hemorrhage.CONCLUSIONSIn ever smokers, both HBP levels and variability are significantly associated with the risk of cerebral infarction. Our findings further validate the benefit of smoking cessation in preventing cardiovascular disease (CVD), especially cerebral infarction.