Does Decreased Diastolic Blood Pressure Associate with Increased Mortality in 80-Year-Old Japanese?
Does Decreased Diastolic Blood Pressure Associate with Increased Mortality in 80-Year-Old Japanese?
复制标题
DOI：
10.3109/10641960903407009
复制
发表时间：
2009-12-01
影响因子：
12.3
通讯作者：
Iida, Mitsuo
中科院分区：
文献类型：
--
作者：
Kagiyama, Shuntaro;Takata, Yutaka;Iida, Mitsuo
高血压是心血管疾病的最大危险因素之一，但其对心血管疾病死亡率的贡献随着年龄的增长而减弱。我们之前已经证明，在日本，80岁的老年人，较高的收缩压（SBP）与死亡率增加无关。然而，我们没有详细研究舒张压（DBP）是否独立影响死亡率。在本研究中，639名1997年80岁的参与者被纳入研究。受试者按舒张压[低于70 mmHg（第1组，n = 136）， 70 ~ 80 mmHg（第2组，n = 200）， 80 ~ 90 mmHg（第3组，n = 194）， 90 mmHg以上（第4组，n = 109）]进行分组。在4年的随访期间，有90人死亡。Cox多因素回归分析显示，1组患者死亡率显著高于4组[相对危险度（RR） 2.47，可信区间（CI） 1.07 ~ 5.70, p = 0.03]。心血管疾病、肺炎和癌症的相对死亡风险I组高于4组，但差异无统计学意义。这些结果表明，舒张压降低与日本老年人较高的死亡率有关。
Hypertension is one of the greatest risk factors for cardiovascular disease, but its contribution to cardiovascular mortality weakens with aging. We have previously demonstrated that at the age of 80, higher systolic blood pressure (SBP) is not correlated with increased mortality in Japan. However, we did not examine in detail whether diastolic blood pressure (DBP) independently affects mortality. In the present study, 639 participants, who were 80 years old in 1997, were enrolled. The subjects were divided by their DBP [below 70 mmHg (group 1, n = 136), from 70 mmHg to 80 mmHg (group 2, n = 200), from 80 mmHg to 90 mmHg (group 3, n = 194), over 90 mmHg (group 4, n = 109)]. During the 4-year follow-up period, 90 individuals died. Cox multivariate regression analysis revealed that group 1 showed a significantly higher mortality rate than group 4 [relative risk (RR) 2.47, confidence interval (CI) 1.07-5.70, p = 0.03)]. The relative risks of deaths from cardiovascular diseases, pneumonia, and cancer tended to be higher in group I than in group 4, but the difference did not reach statistical significance. These results suggest that decreased DBP is associated with higher mortality in the Japanese elderly.