1] Institute of Clinical Medicine/Internal Medicine, University of Oulu, Oulu, Finland [2] Fundación para la Prevención y Control de las Enfermedades Crónicas No-Transmisibles en América Latina (FunPRECAL), Mar del Plata, Argentina [3] Unit of Non-Communicable Diseases, Department of Prevention and Control, Ministry of Health, Bogotá, Colombia.
J Hum Hypertens. 2013 Nov;27(11):693-7. doi: 10.1038/jhh.2013.22. Epub 2013 Mar 21.
The objective of this study (follow-up of 26,113 people) was to investigate differences in the risk of cardiovascular disease (CVD) and all-cause mortality among hypertensive people according to the control of systolic blood pressure (SBP) and diastolic blood pressure (DBP). People with a history of coronary heart disease, heart failure, cancer or incomplete data at baseline (n=1113) were excluded from the study. The participants were classified into six groups according to their blood pressure status. Treated hypertensive individuals with controlled SBP and DBP did not experience an increase in all-cause mortality compared with normotensive people. The increase in all-cause mortality was 1.48-fold (95% confidence interval (CI) 1.09-2.01) among those who were treated with antihypertensive drugs and had only their DBP controlled and 1.45-fold (95% CI 1.04-2.02) among those who were treated and had only their SBP controlled. Treated patients with both SBP and DBP controlled did not have an increased risk of CVD mortality when compared with normotensive people. The risk of CVD mortality was statistically significantly higher in treated hypertensive people with SBP alone, DBP alone or both SBP and DBP uncontrolled. Our study indicates that uncontrolled SBP alone and DBP alone are risk factors of all-cause and CVD mortality.
本研究（随访 26113 人）旨在根据收缩压（SBP）和舒张压（DBP）的控制情况，研究高血压患者发生心血管疾病（CVD）和全因死亡率的差异。患有冠心病、心力衰竭、癌症或基线数据不完整的患者（n=1113）被排除在研究之外。根据血压状况，将参与者分为六组。与血压正常的人相比，接受降压治疗且 SBP 和 DBP 得到控制的高血压患者全因死亡率没有增加。接受降压药物治疗且仅 DBP 得到控制的患者全因死亡率增加 1.48 倍（95%置信区间（CI）1.09-2.01），仅 SBP 得到控制的患者全因死亡率增加 1.45 倍（95% CI 1.04-2.02）。与血压正常的人相比，SBP 和 DBP 均得到控制的治疗患者发生 CVD 死亡率的风险没有增加。与血压正常的人相比，SBP 单独、DBP 单独或 SBP 和 DBP 均未得到控制的治疗高血压患者的 CVD 死亡率风险更高。我们的研究表明，SBP 单独或 DBP 单独不受控制是全因和 CVD 死亡率的危险因素。
