Martins David, Pan Deyu, Karami Nilgoon, Das Debesh, Norris Keith
Department of Internal Medicine at King Drew Medical Center and University of California, Los Angeles, CA.
J Clin Hypertens (Greenwich). 2000 Jul;2(4):248-252.
The rise in systolic blood pressure and the increasing risk of isolated systolic hypertension with advancing age have been attributed, in part, to increased peripheral vascular resistance. Available evidence also suggests that at any given level of arterial pressure, overweight patients with hypertension have a higher cardiac output and a lower total peripheral vascular resistance than lean patients. The lower peripheral resistance associated with overweight patients may attenuate the rise in systolic blood pressure and modify the prevalence of isolated systolic hypertension with age. Using data from the third National Health and Nutrition Examination Survey we examined the relationship between body weight and the age-related rise in systolic blood pressure, and determined the implication of this relationship for the prevalence of isolated systolic hypertension in the older adult population. The age-related rise in systolic blood pressure and the prevalence of isolated systolic hypertension were higher among the lean than in the overweight (odds ratio 1.29 and p value 0.039). The prevalence of isolated systolic hypertension increased by 56% from 6.2% in the fourth to 9.7% in the first body mass index quartile. Among the overweight subjects the prevalence of isolated systolic hypertension continued to decrease until the body mass index exceeded 31.6. OBJECTIVE: To examine the relationship between body weight and the age-related rise in systolic blood pressure, and determine the implication of this relationship for the prevalence of isolated systolic hypertension in the older adult population. DESIGN: A cross-sectional study. SETTING: The study began with a 1-hour home visit for a household interview and ended a few weeks later with a 4-hour physical examination at a mobile examination center. PARTICIPANTS: A sample of the civilian, non-institutionalized population of the U.S. MAIN OUTCOME MEASURES: Age-related rise in systolic blood pressure and the prevalence of isolated systolic hypertension. RESULTS: The age-related rise in systolic blood pressure and the prevalence of isolated systolic hypertension were higher among the lean than in the overweight. The prevalence of isolated systolic hypertension decreased with increased body mass index of 31.6. Systolic blood pressures increased in obese than nonobese subjects. CONCLUSIONS: Body mass index less than 25 is associated with an increase in the age-related rise in systolic blood pressure and the prevalence of isolated systolic hypertension in the older population. (c)2000 by Le Jacq Communications, Inc.
收缩压随年龄增长而升高以及单纯收缩期高血压风险增加，部分原因是外周血管阻力增加。现有证据还表明，在任何给定的动脉压水平下，高血压超重患者的心输出量高于瘦患者，而总外周血管阻力低于瘦患者。超重患者较低的外周阻力可能会减弱收缩压的升高，并改变单纯收缩期高血压随年龄的患病率。利用第三次全国健康和营养检查调查的数据，我们研究了体重与收缩压随年龄增长的关系，并确定了这种关系对老年人群中单纯收缩期高血压患病率的影响。收缩压随年龄增长的升高以及单纯收缩期高血压的患病率在瘦者中高于超重者（优势比1.29，P值0.039）。单纯收缩期高血压的患病率从体重指数四分位数第四组的6.2%增加到第一组的9.7%，增加了56%。在超重受试者中，单纯收缩期高血压的患病率持续下降，直到体重指数超过31.6。目的：研究体重与收缩压随年龄增长的关系，并确定这种关系对老年人群中单纯收缩期高血压患病率的影响。设计：横断面研究。地点：研究开始时进行为期1小时的家访以进行家庭访谈，几周后在流动检查中心进行为期4小时的体格检查结束。参与者：美国非机构化平民人口样本。主要观察指标：收缩压随年龄增长的升高以及单纯收缩期高血压的患病率。结果：收缩压随年龄增长的升高以及单纯收缩期高血压的患病率在瘦者中高于超重者。单纯收缩期高血压的患病率随体重指数增加到31.6而降低。肥胖受试者的收缩压高于非肥胖受试者。结论：体重指数小于25与老年人群中收缩压随年龄增长的升高以及单纯收缩期高血压的患病率增加有关。（c）2000年由Le Jacq通信公司版权所有
