Imperial College London, London, UK.
J Hypertens. 2013 Jan;31(1):71-6. doi: 10.1097/HJH.0b013e32835a4dd8.
High blood pressure is known to be associated with higher cardiovascular risk. The emphasis has shifted over time from diastolic pressure to systolic pressure and variability in blood pressure. This study examined the impact of transient and sustained diastolic hypertension on later mortality.
In the early 1970s, the General Practice Hypertension Study Group screened more than 20,000 patients and selected those with diastolic hypertension, with a transiently elevated diastolic pressure and age-matched and sex-matched normotensive controls to be flagged for long-term death certificate follow-up. After a mean follow-up of 29 years, Cox proportional hazard regression was used to examine the relationship between diastolic hypertension and cause of death.
Overall those with diastolic hypertension and transient diastolic hypertension were at increased risk of total and cardiovascular mortality. When men and women were examined separately, however, the relationships remained significant in women only, with transient diastolic hypertension showing the strongest association with cardiovascular and total mortality: hazard ratio 1.57 [95% confidence interval (CI) 1.11-2.23] and hazard ratio 1.39 (95% CI 1.10-1.76), respectively.
Transient diastolic hypertension does not seem to be benign, particularly in women and may point to those at higher cardiovascular risk when seen in a general practice population.
高血压与较高的心血管风险相关。随着时间的推移，人们的关注点从舒张压转移到了收缩压和血压变异性上。本研究探讨了短暂性和持续性舒张压升高对后期死亡率的影响。
在 20 世纪 70 年代早期，全科医生高血压研究小组对超过 20000 名患者进行了筛查，并选择了那些有短暂性舒张压升高的患者，以及年龄和性别匹配的正常血压对照者，以便进行长期死亡证明随访。在平均随访 29 年后，使用 Cox 比例风险回归来检查舒张压升高与死亡原因之间的关系。
总体而言，舒张压升高和短暂性舒张压升高的患者总死亡率和心血管死亡率都较高。然而，当分别检查男性和女性时，这种关系仅在女性中仍然显著，短暂性舒张压升高与心血管和总死亡率的相关性最强：危险比 1.57（95%置信区间 1.11-2.23）和危险比 1.39（95%置信区间 1.10-1.76）。
短暂性舒张压升高似乎并非良性，尤其是在女性中，这可能表明在一般实践人群中，当出现短暂性舒张压升高时，患者的心血管风险较高。
