Falkstedt Daniel, Koupil Ilona, Hemmingsson Tomas
Division of Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Hypertens. 2008 Jul;26(7):1313-20. doi: 10.1097/HJH.0b013e3282ffb17e.
The association between blood pressure measured in late adolescence and early incidence of coronary heart disease and stroke was investigated in Swedish men. We used measures of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure.
Information on blood pressure at age 18-20 was obtained from a cohort of 49,321 men born in 1949-1951 examined at conscription in 1969/1970. Information on coronary heart disease, acute myocardial infarction, and stroke during 1971-2004 was obtained from national hospital discharge and cause of death registers. Associations between blood pressure and outcomes were estimated with Cox regression as hazard ratios per standard deviation in blood pressure increase in mmHg.
Blood pressure at age 18-20 was found to be associated with coronary heart disease and stroke before 55 years of age. Adjustment for childhood socio-economic position and adolescent smoking, body mass index, and cognitive ability attenuated the associations. Systolic blood pressure was associated with coronary heart disease [hazard ratio (95% confidence interval) 1.09 (1.04, 1.15)] and acute myocardial infarction [1.09 (1.02, 1.17)]. Diastolic blood pressure was associated with coronary heart disease [1.06 (1.00, 1.11)], acute myocardial infarction [1.08 (1.01, 1.15)], and stroke [1.12 (1.04, 1.21)]. Blood pressure measured as mean arterial pressure was significantly associated with coronary heart disease and almost significantly associated with stroke. Pulse pressure had the weakest associations with all outcomes.
Measures of blood pressure in late adolescence were found to be associated with early incidence of coronary heart disease and stroke. Prediction of outcomes differed between measures.
在瑞典男性中研究青春期晚期测量的血压与冠心病和中风早期发病之间的关联。我们使用了收缩压、舒张压、平均动脉压和脉压的测量值。
1969/1970年应征入伍时对49321名出生于1949 - 1951年的男性进行检查，获取了他们18 - 20岁时的血压信息。1971 - 2004年期间冠心病、急性心肌梗死和中风的信息来自国家医院出院记录和死亡原因登记册。血压与结局之间的关联通过Cox回归进行估计，以每毫米汞柱血压升高一个标准差的风险比来表示。
发现18 - 20岁时的血压与55岁之前的冠心病和中风有关。对童年社会经济地位以及青少年吸烟、体重指数和认知能力进行调整后，这种关联减弱。收缩压与冠心病[风险比（95%置信区间）1.09（1.04，1.15）]和急性心肌梗死[1.09（1.02，1.17）]有关。舒张压与冠心病[1.06（1.00，1.11）]、急性心肌梗死[1.08（1.01，1.15）]和中风[1.12（1.04，1.21）]有关。以平均动脉压测量的血压与冠心病显著相关，与中风几乎显著相关。脉压与所有结局的关联最弱。
发现青春期晚期的血压测量值与冠心病和中风的早期发病有关。不同测量值对结局的预测有所不同。
