Cohen Lisa, Curhan Gary C, Forman John P
Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD, USA.
J Am Soc Hypertens. 2012 Jul-Aug;6(4):284-90. doi: 10.1016/j.jash.2012.06.002.
Although hypertension is a highly prevalent disease in older populations, risk factors for developing hypertension have been studied primarily in younger cohorts. We sought to determine whether the strength of traditional hypertensive risk factors varied with age.
We analyzed the prospective association between five modifiable risk factors and hypertension incidence among 78,590 initially nonhypertensive women of different ages in the Nurses' Health Study I cohort over 26 years.
Older age attenuated the association between incident hypertension and four of five risk factors associated with hypertension in younger women. Persons aged 50 years and younger who were low risk for all five risk factor behaviors had a hazard ratio (HR) for incident hypertension of 0.13 (95% confidence interval [CI], 0.03-0.52) compared with others in this age group. In women 61 and older, the HR was 0.62 (95% CI, 0.51-0.75). However, the hypothetical number needed to treat (the number of women needed to join the low-risk-factor group for a 10-year period to prevent one hypertension case) was similar between the age groups.
The fraction of incident hypertension attributable to modifiable lifestyle factors decreases with age. Because the incidence of hypertension is higher in older persons, however, lifestyle modification would hypothetically prevent similar numbers of hypertension cases in younger and older populations.
尽管高血压在老年人群中是一种高度流行的疾病，但高血压发生的风险因素主要是在较年轻的队列中进行研究的。我们试图确定传统高血压风险因素的强度是否随年龄而变化。
我们分析了护士健康研究I队列中78590名初始无高血压的不同年龄女性在26年期间5个可改变风险因素与高血压发病率之间的前瞻性关联。
年龄较大减弱了5个与年轻女性高血压相关的风险因素中4个与高血压发病之间的关联。50岁及以下所有5个风险因素行为均为低风险的人群，与该年龄组中的其他人相比，发生高血压的风险比（HR）为0.13（95%置信区间[CI]，0.03 - 0.52）。在61岁及以上的女性中，HR为0.62（95%CI，0.51 - 0.75）。然而，各年龄组之间的假设治疗所需人数（为预防1例高血压病例，在10年期间需要加入低风险因素组的女性人数）相似。
可改变的生活方式因素导致的高血压发病率随年龄降低。然而，由于老年人中高血压的发病率较高，因此从理论上讲，生活方式的改变在年轻人群和老年人群中预防高血压病例的数量相似。
