ISOLATED SYSTOLIC HYPERTENSION AND SUBCLINICAL CARDIOVASCULAR-DISEASE IN THE ELDERLY - INITIAL FINDINGS FROM THE CARDIOVASCULAR HEALTH STUDY
ISOLATED SYSTOLIC HYPERTENSION AND SUBCLINICAL CARDIOVASCULAR-DISEASE IN THE ELDERLY - INITIAL FINDINGS FROM THE CARDIOVASCULAR HEALTH STUDY
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DOI：
10.1001/jama.268.10.1287
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发表时间：
1992-09-09
影响因子：
120.7
通讯作者：
REID, C
中科院分区：
文献类型：
--
作者：
PSATY, BM;FURBERG, CD;REID, C
目标。目的：评估65岁及以上成人孤立性收缩期高血压（ISH）与亚临床疾病之间的关系。-使用医疗保险资格清单获得5201名社区居住老年人的代表性样本，用于心血管健康研究，这是一项由国家心肺血液研究所赞助的冠心病和中风危险因素队列研究。在基线数据的横断面分析中，我们排除了3012名正在接受降压药物治疗、患有临床心血管疾病或舒张压至少为90mm hg的参与者。-心电图：心肌梗死、左心室肥厚、左心室质量作为心肌损伤和劳损的指标；超声心动图：左心室质量、分数缩短和多普勒血流速度作为心脏收缩和舒张功能的测量；颈动脉超声检查：颈动脉内膜-中膜厚度作为动脉粥样硬化的测量指标。在本分析的2189名男性和女性中，195名（9%）患有ISH（收缩压大于或等于160毫米汞柱），596名（23%）患有边缘性ISH（收缩压，140至159毫米汞柱）。心电图显示收缩压与心肌梗死相关（P= 0.02）。边缘性和明确性ISH与左心室质量密切相关(P
Objective.-To assess the association between isolated systolic hypertension (ISH) and subclinical disease in adults aged 65 years and above.Design.-Medicare eligibility lists were used to obtain a representative sample of 5201 community-dwelling elderly persons for the Cardiovascular Health Study, a National Heart, Lung, and Blood Institute-sponsored cohort study of risk factors for coronary heart disease and stroke. In this cross-sectional analysis of baseline data, we excluded 3012 participants who were receiving antihypertensive medications, had clinical cardiovascular disease, or had a diastolic blood pressure of at least 90 mm Hg.Main Outcome Measures.-For electrocardiogram: myocardial infarction, left ventricular hypertrophy, and left ventricular mass as measures of myocardial damage and strain; for echocardiography: left ventricular mass, fractional shortening, and Doppler flow velocities as measures of cardiac systolic and diastolic function; and for carotid sonography: carotid arterial intima-media thickness as a measure of atherosclerosis.Results.-Among the 2189 men and women in this analysis, 195 (9%) had ISH (systolic blood pressure, greater-than-or-equal-to 160 mm Hg) and 596 (23%) had borderline ISH (systolic blood pressure, 140 to 159 mm Hg). Systolic blood pressure was associated with myocardial infarction by electrocardiogram (P=.02). Borderline and definite ISH were strongly associated with left ventricular mass (P