Cappuccio F P, Strazzullo P, Mancini M
Institute of Internal Medicine and Metabolic Diseases, II Medical School, University of Naples, Italy.
BMJ. 1990 May 12;300(6734):1234-6. doi: 10.1136/bmj.300.6734.1234.
To test the hypothesis that kidney stone disease is more frequent among hypertensive men when the effect of possible confounders is allowed for.
Cross sectional study of a sample of the male working population conducted as part of the 10 year follow up of a nationwide survey of the prevalence of cardiovascular risk factors.
The Olivetti factory in Pozzuoli, a suburban area of Naples.
688 Male workers (87.9% of the male workforce) aged 21-68.
Anthropometric and blood pressure measurements, blood tests, and administration of a detailed questionnaire aimed at detecting a history of urolithiasis.
Prevalence of a history of urolithiasis among normotensive and untreated and treated hypertensive men adjusted for the possible confounding effects of age, body mass index, renal function, and serum urate and total calcium concentrations.
Of the 688 participants 509 were normotensive. Of the remainder, 118 had untreated and 61 treated hypertension. The overall prevalence of a history of urolithiasis was 16.3% (112/688). The relative risk of hypertensive subjects having a history of kidney stones was twice that of the normotensive group (odds ratio 2.11; 95% confidence interval 1.17 to 3.81), the risk being higher when only treated hypertensives were considered (odds ratio 3.16; 95% confidence interval 1.75 to 5.71). The prevalence of a history of urolithiasis was 13.4% (68/509) in the normotensive subjects, 20.3% (24/118) in the untreated hypertensives, and 32.8% (20/61) in the treated hypertensives (p less than 0.001). The age adjusted relative risk in treated hypertensive men was higher than that in the normotensive group (Mantel-Haenszel pooled estimate of odds ratio 2.63; 95% confidence interval 2.23 to 3.10).
An independent clinical association exists between the occurrence of urolithiasis and hypertension. The increased urinary calcium excretion commonly detected in hypertension may be the pathogenetic link.
检验在考虑了可能的混杂因素影响后，高血压男性患肾结石疾病更为常见这一假设。
对男性劳动人口样本进行横断面研究，该研究是一项全国性心血管危险因素患病率调查10年随访的一部分。
那不勒斯郊区波佐利的奥利维蒂工厂。
688名年龄在21 - 68岁的男性工人（占男性劳动力的87.9%）。
进行人体测量和血压测量、血液检测，并发放一份详细问卷以检测尿石症病史。
校正年龄、体重指数、肾功能、血清尿酸盐和总钙浓度可能的混杂影响后，血压正常以及未治疗和已治疗的高血压男性中尿石症病史的患病率。
688名参与者中，509人血压正常。其余参与者中，118人患有未治疗的高血压，61人患有已治疗的高血压。尿石症病史的总体患病率为16.3%（112/688）。有肾结石病史的高血压患者的相对风险是血压正常组的两倍（比值比2.11；95%置信区间1.17至3.81），仅考虑已治疗的高血压患者时风险更高（比值比3.16；95%置信区间1.75至5.71）。血压正常的受试者中尿石症病史的患病率为13.4%（68/509），未治疗的高血压患者中为20.3%（24/118），已治疗的高血压患者中为32.8%（20/61）（p<0.001）。校正年龄后，已治疗的高血压男性的相对风险高于血压正常组（Mantel - Haenszel合并比值比估计值为2.63；95%置信区间2.23至3.10）。
尿石症的发生与高血压之间存在独立的临床关联。高血压患者中常见的尿钙排泄增加可能是致病联系。
