Iseki K, Kimura Y, Wakugami K, Okumura K, Muratani H, Ikemiya Y, Fukiyama K
Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan.
Hypertens Res. 2000 Mar;23(2):143-9. doi: 10.1291/hypres.23.143.
Hypertension is a known risk factor for cardiovascular disease, but few epidemiological studies have examined simultaneously the effect of baseline blood pressure on the development of stroke, acute myocardial infarction (AMI), and end-stage renal disease (ESRD). In 1983, a large, community-based mass screening covered about 14% of the adult population in Okinawa, Japan. The total number of people screened was 107,192 (51,122 men, 56,070 women). We had access to two independent registries of end-organ damage: the Co-operative Study Group of Morbidity and Mortality of Cardiovascular Diseases in Okinawa (COSMO) registry for stroke and AMI, and the Okinawa Dialysis Study (OKIDS) registry for ESRD. The total number of people registered was 4,756 with stroke, 1,059 with AMI, and 641 with ESRD during the study period from April 1, 1988, to March 31, 1991. By using the name, sex, birth date, and ZIP code of registrants, we identified those registrants who were screened in 1983 and had developed stroke, AMI, or ESRD. Hypertension was defined as systolic blood pressure (SBP) of 140 mmHg or higher or diastolic blood pressure (DBP) of 90 mmHg or higher. Other readings were regarded as normotensive. The prevalence of hypertension was 35.8% (N=37,299). The cumulative incidence of stroke, AMI, and ESRD was 154, 21, and 19 subjects among those with SBP < or = 119 mmHg, and 1933, 315, and 71 subjects among those with SBP > or = 160 mmHg. Similarly, the incidence of stroke, AMI, and ESRD was 234, 44, and 25 subjects among those with DBP < or = 69 mmHg and 1980, 381, and 364 subjects among those with DBP > or = 110 mmHg. Hypertension was prevalent in the adult population in Okinawa, Japan, and was a significant predictor of stroke, AMI, and ESRD. However, the effect of blood pressure on target organs differed and was more evident in those with stroke than in those with AMI and ESRD.
高血压是心血管疾病的一个已知风险因素，但很少有流行病学研究同时考察基线血压对中风、急性心肌梗死（AMI）和终末期肾病（ESRD）发病的影响。1983年，在日本冲绳开展了一项大规模的社区群体筛查，覆盖了约14%的成年人口。筛查的总人数为107,192人（男性51,122人，女性56,070人）。我们可以查阅两个独立的终末器官损害登记册：冲绳心血管疾病发病率和死亡率合作研究组（COSMO）登记册，用于记录中风和AMI；以及冲绳透析研究（OKIDS）登记册，用于记录ESRD。在1988年4月1日至1991年3月31日的研究期间，登记的中风患者有4,756人，AMI患者有1,059人，ESRD患者有641人。通过使用登记人的姓名、性别、出生日期和邮政编码，我们确定了那些在1983年接受过筛查且后来发生中风、AMI或ESRD的登记人。高血压定义为收缩压（SBP）140 mmHg及以上或舒张压（DBP）90 mmHg及以上。其他读数视为血压正常。高血压患病率为35.8%（N = 37,299）。在SBP≤119 mmHg的人群中，中风、AMI和ESRD的累积发病率分别为154例、21例和19例；在SBP≥160 mmHg的人群中，分别为1933例、315例和71例。同样，在DBP≤69 mmHg的人群中，中风、AMI和ESRD的发病率分别为234例、44例和25例；在DBP≥110 mmHg的人群中，分别为1980例、381例和364例。高血压在日本冲绳的成年人群中普遍存在，并且是中风、AMI和ESRD的一个重要预测因素。然而，血压对靶器官的影响有所不同，在中风患者中比在AMI和ESRD患者中更明显。
