Blood pressure usually considered normal is associated with an elevated risk of cardiovascular disease
Blood pressure usually considered normal is associated with an elevated risk of cardiovascular disease
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DOI：
10.1016/j.amjmed.2005.08.023
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发表时间：
2006-02-01
影响因子：
5.9
通讯作者：
Colindres, RE
中科院分区：
文献类型：
--
作者：
Kshirsagar, AV;Carpenter, M;Colindres, RE
目的：关于高血压前期（血压 120/80 至 139/89 mm Hg）个体心血管疾病风险的研究尚不完整。心血管疾病并发症高风险个体的更多信息可能有助于集中当前和未来的努力。 主题和方法：我们在社区动脉粥样硬化风险 (ARIC) 研究中对 8960 名中年人进行了前瞻性队列分析。暴露变量为血压水平：正常高血压，收缩压130-139毫米汞柱或舒张压85-89毫米汞柱：以及正常血压，收缩压120-129毫米汞柱或舒张压80-84毫米汞柱。结果是心血管疾病事件，定义为致命/非致命冠心病、心脏手术、无症状心肌梗死或缺血性中风。在黑人、糖尿病患者、55-64岁个体、肾功能不全个体以及具有不同水平低密度脂蛋白（LDL）胆固醇和体重指数（BMI）的个体中进行亚组分析。结果：与最佳血压（收缩压<120mmHe和舒张压<80mmHg）相比，正常高血压导致心血管疾病的相对风险（RR）为2.33 （95% 置信区间 [CI]，1.85-2.92），正常血压的 RR 为 1.81（1.47-2.22）；黑人中：正常高血压的 RR 为 3.29（95% CI，1.68-6.45）；糖尿病患者：正常高血压的 RR 为 4.10（95% CI，2.26-7.46）：年龄 55-64 岁：正常高血压的 RR 为 2.41（95% CI，1.75-3.30） 肾功能不全患者：正常高血压的 RR 为 1.90（95% CI，1.34-2.70）； BMI > 30 kg/m(2) 的个体中：正常高血压的 RR 为 3.56（95% CI，1.99-6.35）；在 LDL > 160 mg/dL 的个体中，正常高血压的 RR 为 1.85（95% CI，1.26-2.72）。结论：与最佳血压水平的个体相比，处于高血压前期水平的个体患心血管疾病的风险增加。这种关联在黑人、糖尿病患者和高体重指数人群中尤为明显。 (c) 2006 Elsevier Inc. 保留所有权利。
PURPOSE: Research on the risk of cardiovascular disease among individuals with prehypertension (blood pressure 120/80 to 139/89 mm Hg) is incomplete. Additional information among individuals with a high risk of cardiovascular disease complications may help to focus current and future efforts.SUBJECTS AND METHODS: We performed a prospective cohort analysis among 8960 middle-aged adults in the Atherosclerosis Risk in Communities (ARIC) study. The exposure variables were blood pressure levels: high normal blood pressure, systolic blood pressure 130-139 mm Hg or diastolic blood pressure 85-89 mm Hg: and normal blood pressure, systolic blood pressure 120-129 mm Hg or diastolic blood pressure 80-84 mm Hg. The outcome was incident cardiovascular disease defined as fatal/nonfatal coronary heart disease, cardiac procedure, silent myocardial infarction, or ischemic stroke. Subgroup analysis was performed among blacks, diabetics, individuals aged 55-64 years, individuals with renal insufficiency, and among individuals with varying levels of low-density lipoprotein (LDL) cholesterol and body mass index (BMI).RESULTS: Compared with optimal blood pressure (systolic blood pressure < 120 mm He and diastolic blood pressure < 80 mm Hg), the relative risk (RR) of cardiovascular disease for high normal blood pressure was 2.33 (95% confidence interval [CI], 1.85-2.92), and RR for normal blood pressure was 1.81 (1.47-2.22); among blacks: RR for high normal blood pressure was 3.29 (95% CI, 1.68-6.45); among diabetics: RR for high normal blood pressure 4.10 (95% CI, 2.26-7.46): age 55-64 years: RR for high normal blood pressure 2.41 (95% CI, 1.75-3.30) among individuals with renal insufficiency: RR for high normal blood pressure was 1.90 (95% CI, 1.34-2.70); among individuals with BMI > 30 kg/m(2): RR for high normal blood pressure was 3.56 (95% CI, 1.99-6.35); and among individuals with LDL > 160 mg/dL, RR for high normal blood pressure was 1.85 (95% CI, 1.26-2.72).CONCLUSIONS: Individuals with prehypertensive levels of blood pressure have an increased risk of developing cardiovascular disease relative to those with optimal levels. The association is pronounced among blacks, among individuals with diabetes mellitus, and among those with high BMI. (c) 2006 Elsevier Inc. All rights reserved.