Metoki Hirohito, Ohkubo Takayoshi, Kikuya Masahiro, Asayama Kei, Obara Taku, Hara Azusa, Hirose Takuo, Hashimoto Junichiro, Totsune Kazuhito, Hoshi Haruhisa, Satoh Hiroshi, Imai Yutaka
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
J Hypertens. 2006 Sep;24(9):1841-8. doi: 10.1097/01.hjh.0000242409.65783.fb.
To clarify whether high blood pressure (BP) at a particular time of day is associated with cerebrovascular and cardiovascular mortality risk.
Cerebrovascular and cardiovascular mortality in 1360 individuals aged 40 years and older in Ohasama, Japan, was followed for an average of 10.6 years. We used 2-h moving averages of the BP (a total of 24 average BP measurements for two consecutive hours based on four BP readings taken every 30 min) to compare the predictive power of BP taken during a 24-h period given the same number of measurements. The associations between cerebrovascular and cardiovascular mortality risk and the 2-h moving averages of systolic blood pressure (2 h-SBP) recorded over 24 h were analysed using a Cox proportional hazards model after adjusting for possible confounding factors.
The total cerebrovascular and cardiovascular mortality risk was significantly associated with elevated 2 h-SBP recorded during the night and early morning periods. Haemorrhagic stroke mortality was significantly associated with elevated daytime 2 h-SBP. Cerebral infarction mortality and heart disease mortality were significantly associated with elevated night-time 2 h-SBP.
High BP at different times of day were associated with different subtypes of cerebrovascular and cardiovascular mortality risk.
明确一天中特定时间的高血压是否与脑血管和心血管疾病死亡风险相关。
对日本大岛地区1360名40岁及以上个体的脑血管和心血管疾病死亡率进行了平均10.6年的随访。我们使用血压的2小时移动平均值（基于每30分钟测量一次的四次血压读数，连续两小时共进行24次平均血压测量），在测量次数相同的情况下，比较24小时内不同时段测量的血压的预测能力。在调整可能的混杂因素后，使用Cox比例风险模型分析脑血管和心血管疾病死亡风险与24小时内记录的收缩压2小时移动平均值（2h-SBP）之间的关联。
脑血管和心血管疾病的总死亡风险与夜间和清晨时段记录的2h-SBP升高显著相关。出血性卒中死亡率与白天2h-SBP升高显著相关。脑梗死死亡率和心脏病死亡率与夜间2h-SBP升高显著相关。
一天中不同时间的高血压与脑血管和心血管疾病死亡风险的不同亚型相关。
