Ohkubo Takayoshi, Asayama Kei, Kikuya Masahiro, Metoki Hirohito, Obara Taku, Saito Shin, Hoshi Haruhisa, Hashimoto Junichiro, Totsune Kazuhito, Satoh Hiroshi, Imai Yutaka
Departments of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Iwate, Japan.
Blood Press Monit. 2004 Dec;9(6):315-20. doi: 10.1097/00126097-200412000-00009.
To examine the predictive value of self-measured blood pressure values taken at home (home blood pressure) for risk of stroke and subtypes.
We obtained home blood pressure measurements from 1702 people, aged > or =40 years, without a history of stroke, in the general population in Japan, and continued follow-up after a mean period of 10.6 years. The prognostic significance of blood pressure for stroke risk was examined using the Cox proportional hazards regression model, which was adjusted for possible confounding factors.
There was a linear relationship between home blood pressure and risk of stroke and subtypes. On average, each 10/5 mmHg elevation in home systolic/diastolic blood pressure respectively, was associated with an approximately 30/20% respectively, higher risk of total stroke. A similar relationship was observed for the risk of haemorrhagic stroke (intracerebral and subarachnoid haemorrhage), and the risk of ischaemic stroke [cerebral infarction and transient ischaemic attack (TIA)]. The risk of stroke and subtypes showed a significantly greater relation with home blood pressure values compared to conventional blood pressure values.
This is the first study to demonstrate that home blood pressure is an independent predictor for haemorrhagic and ischaemic stroke, in the general population.
探讨家庭自测血压值（家庭血压）对中风风险及其亚型的预测价值。
我们获取了日本普通人群中1702名年龄≥40岁且无中风病史者的家庭血压测量值，并在平均10.6年的时间里持续进行随访。使用Cox比例风险回归模型检验血压对中风风险的预后意义，并对可能的混杂因素进行了校正。
家庭血压与中风风险及其亚型之间存在线性关系。平均而言，家庭收缩压/舒张压每升高10/5 mmHg，分别与总中风风险升高约30/20%相关。出血性中风（脑内出血和蛛网膜下腔出血）风险以及缺血性中风[脑梗死和短暂性脑缺血发作（TIA）]风险也呈现类似关系。与传统血压值相比，中风风险及其亚型与家庭血压值的关联更为显著。
本研究首次表明，在普通人群中，家庭血压是出血性和缺血性中风的独立预测指标。
