Wingfield D, Grodzicki T, Palmer A J, Wells F, Bulpitt C J
Brook Green Medical Centre, Bute Gardens, London, UK.
J Hum Hypertens. 2005 May;19(5):347-54. doi: 10.1038/sj.jhh.1001825.
We assessed the morbidity and mortality of subjects with transiently elevated diastolic pressure in the General Practice Hypertension Study Group (GPHSG) population. A total of 23 578 patients (aged 18-65 years) from seven UK general practices were screened in 1974 for a diastolic blood pressure (DBP4) of > or = 90 mmHg. Two further readings of DBP4 determined hypertensive (either DBP4 > or = 90 mmHg) or transient hypertensive (both DBP4 < 90 mmHg) status. Transients (n = 850) were matched with normotensive controls (n = 824) and risk ratios calculated over a mean follow-up of 18.7 years. Rescreening was conducted in six of the practices (n = 20 942) after 7.7 years. Male transients had a higher relative hazard for cardiovascular mortality than controls (11.8%, 8.6%, adjusted relative hazard 1.59, P = 0.056). Female transients had a lower relative hazard for cardiovascular mortality than controls (3.6%, 5.4%, adjusted relative hazard 0.39, P = 0.018). In all, 422 patients with transient hypertension were rescreened along with 367 matched controls. Significantly more transients were on antihypertensive treatment compared with their controls (odds ratio (OR) [95% CI]) for both male (4.2 [1.6-11.1]) and female patients (2.4 [1.0-5.56]) and more untreated female transients developed hypertension. Male transients had a higher rates of diabetes mellitus (adj OR = 5.1, P = 0.04) and stroke (adj OR 15.9, P = 0.03). This study has shown that transiently elevated DBP in GPHSG is associated with a significantly higher risk of later hypertension in men and women and of diabetes, stroke and cardiovascular mortality in men. Women with this condition have a significantly lower cardiovascular mortality.
我们在全科医疗高血压研究组（GPHSG）人群中评估了舒张压短暂升高的受试者的发病率和死亡率。1974年，对来自英国7家全科医疗机构的总共23578名患者（年龄在18至65岁之间）进行了筛查，以检测舒张压（DBP4）是否≥90 mmHg。另外两次DBP4读数确定了高血压（DBP4≥90 mmHg）或短暂性高血压（两次DBP4均<90 mmHg）状态。将短暂性高血压患者（n = 850）与血压正常的对照组（n = 824）进行匹配，并在平均18.7年的随访期内计算风险比。7.7年后，在其中6家医疗机构（n = 20942）进行了重新筛查。男性短暂性高血压患者心血管死亡的相对风险高于对照组（分别为11.8%、8.6%；调整后的相对风险为1.59，P = 0.056）。女性短暂性高血压患者心血管死亡的相对风险低于对照组（分别为3.6%、5.4%；调整后的相对风险为0.39，P = 0.018）。共有422名短暂性高血压患者和367名匹配对照组接受了重新筛查。与对照组相比，接受抗高血压治疗的短暂性高血压患者明显更多，男性患者（比值比（OR）[95%置信区间]）为4.2 [1.6 - 11.1]，女性患者为2.4 [1.0 - 5.56]，且更多未接受治疗的女性短暂性高血压患者发展为高血压。男性短暂性高血压患者患糖尿病（调整后的OR = （此处原文可能有误，推测为5.1），P =（此处原文可能有误，推测为0.04））和中风（调整后的OR =（此处原文可能有误，推测为15.9），P =（此处原文可能有误，推测为0.03））的比例更高。这项研究表明，GPHSG中舒张压短暂升高与男性和女性日后患高血压的风险显著升高以及男性患糖尿病、中风和心血管死亡的风险显著升高相关。患有这种情况的女性心血管死亡率显著较低。
