Association of all-cause and cardiovascular mortality with prehypertension: A meta-analysis
Association of all-cause and cardiovascular mortality with prehypertension: A meta-analysis
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DOI：
10.1016/j.ahj.2013.10.023
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发表时间：
2014-02-01
影响因子：
4.8
通讯作者：
Xu, Dingli
中科院分区：
文献类型：
--
作者：
Huang, Yuli;Su, Liang;Xu, Dingli
背景在调整其他心血管危险因素后，高血压前期和死亡率的研究仍存在争议。本荟萃分析旨在评估高血压前期与全因和心血管疾病（CVD）mortality.Methods的PubMed，EMBASE，科克伦图书馆数据库，和会议论文集的研究与高血压前期和死亡率的数据进行了搜索。计算全因、CVD、冠心病（CHD）和卒中死亡率的相对风险（RR），并提供95% CI。根据血压，年龄，性别，种族，随访时间，参与者数量和研究characteristics.Results数据来自1,129,098名参与者来自20个前瞻性队列研究进行亚组分析。高血压前期显著增加心血管疾病、冠心病和卒中死亡率的风险（RR 1.28，95% CI 1.16-1.40; RR 1.12，95% CI 1.02-1.23; RR 1.41，95%CI 1.28-1.56），但经多变量校正后，未增加全因死亡率的风险（RR 1.03，95% CI 0.97-1.10）。冠心病死亡率与脑卒中死亡率之间有显著性差异（P <0.001）。亚组分析显示，高血压前期患者CVD死亡率显著增加（RR 1.28，95% CI 1.16-1.41），而低血压前期患者CVD死亡率无显著增加（RR 1.08，95% CI 0.98-1.18）。CVD死亡的风险主要由高范围的高血压前期驱动。
Background Studies of prehypertension and mortality are controversial after adjusting for other cardiovascular risk factors. This meta-analysis sought to evaluate the association of prehypertension with all-cause and cardiovascular disease (CVD) mortality.Methods The PubMed, EMBASE, Cochrane Library databases, and conference proceedings were searched for studies with data on prehypertension and mortality. The relative risks (RRs) of all-cause, CVD, coronary heart disease (CHD), and stroke mortality were calculated and presented with 95% CIs. Subgroup analyses were conducted according to blood pressure, age, gender, ethnicity, follow-up duration, participant number, and study characteristics.Results Data from 1,129,098 participants were derived from 20 prospective cohort studies. Prehypertension significantly increased the risk of CVD, CHD, and stroke mortality (RR 1.28, 95% CI 1.16-1.40; RR 1.12, 95% CI 1.02-1.23; and RR 1.41, 95% CI 1.28-1.56, respectively), but did not increase the risk of all-cause mortality after multivariate adjustment (RR 1.03, 95% CI 0.97-1.10). The difference between CHD mortality and stroke mortality was significant (P < .001). Subgroup analyses showed that CVD mortality was significantly increased in high-range prehypertension (RR 1.28, 95% CI 1.16-1.41) but not in low-range prehypertension (RR 1.08, 95% CI 0.98-1.18).Conclusion Prehypertension is associated with CVD mortality, especially with stroke mortality, but not with all-cause mortality. The risk for CVD mortality is largely driven by high-range prehypertension.