Blood Pressure Classification of 2017 Associated With Cardiovascular Disease and Mortality in Young Chinese Adults
Blood Pressure Classification of 2017 Associated With Cardiovascular Disease and Mortality in Young Chinese Adults
复制标题
DOI：
10.1161/hypertensionaha.119.14239
复制
发表时间：
2020-07-01
期刊：
影响因子：
8.3
通讯作者：
Jonas, Jost B.
中科院分区：
文献类型：
--
作者：
Wu, Shouling;Song, Yongjian;Jonas, Jost B.
美国心脏病学会/美国心脏协会于 2017 年推出了新的血压 (BP) 分类指南。我们探讨了新定义的分类与中国年轻人最终心血管疾病 (CVD) 事件、中风和全因死亡率之间的关联。在以社区为基础的开滦研究中，对2006/2007年基线检查的16 006名年龄在18至40岁的参与者进行了为期两年的随访检查，直至2016年至2017年。采用2006年至2007年手动血压计记录的基线最高血压读数，根据新指南对血压进行分类。结果参数包括心血管疾病事件、中风和全因死亡率。在随访期间（平均：10.9 +/- 0.63 年），我们观察到 458 起事件（CVD，167 起；中风，119 起；全因死亡，172 起）。多变量调整后，与正常血压相比，CVD事件的风险比为血压升高0.80（95% CI，0.28-2.30）、1期高血压1.82（95% CI，1.12-2.94）和2期高血压3.54（95% CI，2.18-5.77）。中风和全因死亡也获得了类似的结果。在将血压类别输入为时间依赖性协变量的 Cox 回归分析中，1 期高血压与风险增加无关（P>0.10）。在随访期间服用抗高血压药物的亚组中，没有任何血压类别与 CVD 事件的发生率显着相关。在平均 10.9 年的随访期间，新定义的 1 期高血压类别在未经治疗的中国年轻成年人中
The American College of Cardiology/American Heart Association introduced new guidelines for blood pressure (BP) classification in 2017. We explored associations between the newly defined categories and eventual cardiovascular disease (CVD) events, stroke, and all-cause mortality in young Chinese adults. In the community-based Kailuan Study, 16 006 participants aged 18 to 40 years and examined at baseline in 2006/2007 underwent 2-yearly follow-up examinations up to 2016 to 2017. Taking the highest BP reading recorded by manual sphygmomanometry at baseline in 2006 to 2007, we categorized the BP according to the new guidelines. Outcome parameters were CVD events, stroke, and all-cause mortality. During follow-up (mean: 10.9 +/- 0.63 years), we observed 458 events (CVD, 167; stroke, 119; and all-cause death, 172). After multivariable adjustment, hazard ratios for CVD events were for elevated BP 0.80 (95% CI, 0.28-2.30), stage 1 hypertension 1.82 (95% CI, 1.12-2.94), and stage 2 hypertension 3.54 (95% CI, 2.18-5.77) versus normal BP. Similar results were obtained for stroke and all-cause death. In Cox regression analysis with BP category entered as time-dependent covariate, stage 1 hypertension was not associated with increased risk (P>0.10). In the subgroup of individuals taking antihypertensive medication during follow-up, none of the BP categories was significantly associated with the incidence of CVD events. During a mean follow-up of 10.9 years, the newly defined category of stage 1 hypertension in young untreated Chinese adults aged