Medical Research Council Unit for Lifelong Health and Ageing, Department of Epidemiology and Public Health, University College London, London, United Kingdom.
PLoS Med. 2011 Jun;8(6):e1000440. doi: 10.1371/journal.pmed.1000440. Epub 2011 Jun 14.
Much of our understanding of the age-related progression of systolic blood pressure (SBP) comes from cross-sectional data, which do not directly capture within-individual change. We estimated life course trajectories of SBP using longitudinal data from seven population-based cohorts and one predominantly white collar occupational cohort, each from the United Kingdom and with data covering different but overlapping age periods.
Data are from 30,372 individuals and comprise 102,583 SBP observations spanning from age 7 to 80+y. Multilevel models were fitted to each cohort. Four life course phases were evident in both sexes: a rapid increase in SBP coinciding with peak adolescent growth, a more gentle increase in early adulthood, a midlife acceleration beginning in the fourth decade, and a period of deceleration in late adulthood where increases in SBP slowed and SBP eventually declined. These phases were still present, although at lower levels, after adjusting for increases in body mass index though adulthood. The deceleration and decline in old age was less evident after excluding individuals who had taken antihypertensive medication. Compared to the population-based cohorts, the occupational cohort had a lower mean SBP, a shallower annual increase in midlife, and a later midlife acceleration. The maximum sex difference was found at age 26 (+8.2 mm Hg higher in men, 95% CI: 6.7, 9.8); women then experienced steeper rises and caught up by the seventh decade.
Our investigation shows a general pattern of SBP progression from childhood in the UK, and suggests possible differences in this pattern during adulthood between a general population and an occupational population. Please see later in the article for the Editors' Summary.
我们对收缩压（SBP）随年龄增长的过程的大部分了解都来自横断面数据，这些数据并不能直接捕捉个体内的变化。我们使用来自七个基于人群的队列和一个主要为白领职业队列的纵向数据来估计 SBP 的生命历程轨迹，这些队列都来自英国，数据涵盖了不同但重叠的年龄期。
数据来自 30372 人，包括从 7 岁到 80 岁以上的 102583 次 SBP 观察。对每个队列都拟合了多层次模型。在两性中都存在四个生命历程阶段：与青春期生长高峰同时发生的 SBP 快速增加，成年早期更温和的增加，中年开始的中期加速，以及老年后期的减速阶段，SBP 增加速度放缓，最终下降。尽管在整个成年期调整了体重指数的增加，但这些阶段仍然存在，尽管水平较低。在排除服用抗高血压药物的个体后，老年时的减速和下降不那么明显。与基于人群的队列相比，职业队列的平均 SBP 较低，中年的年增长率较浅，中年加速较晚。最大的性别差异出现在 26 岁（男性高 8.2 毫米汞柱，95%置信区间：6.7，9.8）；然后女性经历了更陡峭的上升，并在第七个十年赶上了男性。
我们的研究表明，英国儿童时期 SBP 有一个普遍的发展模式，并表明在一般人群和职业人群之间，成年期的这种模式可能存在差异。请在文章后面查看编辑摘要。
