Hardoon Sarah L, Whincup Peter H, Wannamethee S Goya, Lennon Lucy T, Capewell Simon, Morris Richard W
Department of Primary Care and Population Health, Division of Population Health, UCL, London, UK.
Eur J Cardiovasc Prev Rehabil. 2010 Oct;17(5):502-8. doi: 10.1097/HJR.0b013e3283378865.
To investigate the role of medication in 20-year trends in blood pressure (BP) and blood lipids in older British men.
BP and lipids were measured in 4231 men from a representative cohort at baseline (1978-1980, aged 40-59 years) and after 20 years (1998-2000). Cohort-wide age-adjusted 20-year mean changes were as follows: systolic BP -7.6 mmHg (95% confidence interval: -9.7 to -5.4); diastolic BP +3.3 mmHg (+2.2 to +4.5); non-high-density lipoprotein (HDL)-cholesterol -0.4 mmol/l (-0.5 to -0.2); HDL-cholesterol +0.16 mmol/l (+0.13 to +0.19). Much (79%) of the systolic BP fall occurred only among 1561 men (37%) reporting the use of BP-lowering medication during the follow-up; systolic BP changed by -12.3 mmHg (-14.7 to -9.9) and -1.6 mmHg (-3.7 to +0.5) among medication users and men not using medication, respectively (P<0.001 for medication-time interaction). One-third of the non-HDL-cholesterol fall occurred only among 302 men (8%) reporting the use of lipid-regulating drugs; non-HDL-cholesterol changed by -1.8 mmol/l (-2.0 to -1.6) and -0.2 mmol/l (-0.4 to -0.1) among medication users and men not using medication, respectively (P<0.001 for interaction). The HDL-cholesterol increase was not associated with lipid-regulating drug use (P=0.15 for interaction).
Decreases in BP were largely confined to medication users and overall changes in non-HDL-cholesterol were modest, suggesting the need for greater efforts to reduce BP and cholesterol among the general population. HDL-cholesterol increased among all men, likely reflecting cohort-wide improvements in associated health behaviours.
探讨药物治疗在英国老年男性血压(BP)和血脂20年变化趋势中的作用。
对来自一个代表性队列的4231名男性在基线时(1978 - 1980年,年龄40 - 59岁)及20年后(1998 - 2000年)测量血压和血脂。全队列年龄校正后的20年平均变化如下:收缩压 -7.6 mmHg(95%置信区间:-9.7至 -5.4);舒张压 +3.3 mmHg(+2.2至 +4.5);非高密度脂蛋白(HDL)胆固醇 -0.4 mmol/l(-0.5至 -0.2);HDL胆固醇 +0.16 mmol/l(+0.13至 +0.19)。收缩压下降的大部分(79%)仅发生在随访期间报告使用降压药物的1561名男性(37%)中;使用药物者和未使用药物者的收缩压分别变化 -12.3 mmHg(-14.7至 -9.9)和 -1.6 mmHg(-3.7至 +0.5)(药物使用时间交互作用P<0.001)。非HDL胆固醇下降的三分之一仅发生在报告使用调脂药物的302名男性(8%)中;使用药物者和未使用药物者的非HDL胆固醇分别变化 -1.8 mmol/l(-2.0至 -1.6)和 -0.2 mmol/l(-0.4至 -0.1)(交互作用P<0.001)。HDL胆固醇升高与调脂药物使用无关(交互作用P = 0.15)。
血压下降主要局限于药物使用者,非HDL胆固醇的总体变化不大,这表明需要加大力度在普通人群中降低血压和胆固醇。所有男性的HDL胆固醇均升高,这可能反映了全队列在相关健康行为方面的改善。