Department of Cardiology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China.
BMC Med. 2013 Aug 2;11:177. doi: 10.1186/1741-7015-11-177.
Prospective cohort studies of prehypertension and the incidence of cardiovascular disease (CVD) are controversial after adjusting for other cardiovascular risk factors. This meta-analysis evaluated the association between prehypertension and CVD morbidity.
Databases (PubMed, EMBASE and the Cochrane Library) and conference proceedings were searched for prospective cohort studies with data on prehypertension and cardiovascular morbidity. Two independent reviewers assessed the reports and extracted data. The relative risks (RRs) of CVD, coronary heart disease (CHD) and stroke morbidity were calculated and reported with 95% confidence intervals (95% CIs). Subgroup analyses were conducted on blood pressure, age, gender, ethnicity, follow-up duration, number of participants and study quality.
Pooled data included the results from 468,561 participants from 18 prospective cohort studies. Prehypertension elevated the risks of CVD (RR = 1.55; 95% CI = 1.41 to 1.71); CHD (RR = 1.50; 95% CI = 1.30 to 1.74); and stroke (RR = 1.71; 95% CI = 1.55 to 1.89). In the subgroup analyses, even for low-range prehypertension, the risk of CVD was significantly higher than for optimal BP (RR = 1.46, 95% CI = 1.32 to 1.62), and further increased with high-range prehypertension (RR = 1.80, 95% CI = 1.41 to 2.31). The relative risk was significantly higher in the high-range prehypertensive populations than in the low-range populations (χ2= 5.69, P = 0.02). There were no significant differences among the other subgroup analyses (P>0.05).
Prehypertension, even in the low range, elevates the risk of CVD after adjusting for multiple cardiovascular risk factors.
调整其他心血管风险因素后，前瞻性队列研究显示，高血压前期与心血管疾病（CVD）的发病率之间存在争议。本荟萃分析评估了高血压前期与 CVD 发病率之间的关系。
检索了包含高血压前期和心血管发病率数据的前瞻性队列研究的数据库（PubMed、EMBASE 和 Cochrane Library）和会议论文集。两名独立的评审员评估了报告并提取了数据。计算了 CVD、冠心病（CHD）和中风发病率的相对风险（RR），并报告了 95%置信区间（95%CI）。对血压、年龄、性别、种族、随访时间、参与者数量和研究质量进行了亚组分析。
汇总数据包括来自 18 项前瞻性队列研究的 468,561 名参与者的结果。高血压前期使 CVD（RR = 1.55；95%CI = 1.41 至 1.71）、CHD（RR = 1.50；95%CI = 1.30 至 1.74）和中风（RR = 1.71；95%CI = 1.55 至 1.89）的风险升高。在亚组分析中，即使是低范围的高血压前期，CVD 的风险也明显高于最佳血压（RR = 1.46，95%CI = 1.32 至 1.62），并随着高范围高血压前期而进一步增加（RR = 1.80，95%CI = 1.41 至 2.31）。高范围高血压前期人群的相对风险明显高于低范围人群（χ2= 5.69，P = 0.02）。其他亚组分析之间没有显著差异（P>0.05）。
即使在低范围，高血压前期也会在调整多种心血管风险因素后增加 CVD 的风险。
