Stranges Saverio, Donahue Richard P
aDivision of Health Sciences, University of Warwick Medical School, Coventry, UK bDepartment of Epidemiology & Environmental Health, State University of New York at Buffalo, Buffalo, New York, USA.
J Hypertens. 2015 Apr;33(4):720-6; discussion 726. doi: 10.1097/HJH.0000000000000465.
Measures of health-related quality of life (HRQL) are strong predictors of health outcomes including cardiovascular disease (CVD). However, prospective evidence on the potential impact of these measures on hypertension risk is scant. We therefore examined the independent role of HRQL on the risk of hypertension in a 6-year longitudinal investigation among 979 women and men (mean age 54.3 years) from the community, who were free of hypertension, CVD and diabetes at the baseline examination.
Baseline variables included socio-demographics, anthropometrics, blood pressure, behavioural risk factors and measures of HRQL, such as the physical and mental health component summaries of the short form-36 questionnaire (SF-36). Incident hypertension was defined as blood pressure at least 140/90 mmHg or on antihypertensive medication at the follow-up visit.
The cumulative 6-year incidence of hypertension was 21.9% (214/979). In bivariate analyses, there were several baseline correlates of incident hypertension, including age, abdominal height, BMI and baseline blood pressure levels in both sexes, whereas impaired fasting glucose, family history of hypertension and the SF-36 physical score were all significantly associated with hypertension among women only. After multivariate adjustment, the SF-36 physical scores [odds ratio (OR) 0.97, 0.94-0.99 for unit change] were still significant predictors of hypertension in women only, independent of age, anthropometrics, baseline SBP levels, behavioural risk factors and other covariates.
Measures of HRQL may represent independent predictors of hypertension risk, at least among women, above and beyond the role of traditional risk factors, such as age, anthropometrics and genetic predisposition.
健康相关生活质量（HRQL）指标是包括心血管疾病（CVD）在内的健康结局的有力预测指标。然而，关于这些指标对高血压风险潜在影响的前瞻性证据却很少。因此，我们在一项为期6年的纵向研究中，对来自社区的979名男性和女性（平均年龄54.3岁）进行了研究，这些人在基线检查时没有高血压、心血管疾病和糖尿病，以探讨HRQL在高血压风险中的独立作用。
基线变量包括社会人口统计学、人体测量学、血压、行为危险因素以及HRQL指标，如简短36项问卷（SF-36）的身心健康分量表总分。新发高血压定义为随访时血压至少为140/90 mmHg或正在服用降压药。
高血压的6年累积发病率为21.9%（214/979）。在双变量分析中，有几个与新发高血压相关的基线因素，包括年龄、腹围、体重指数以及男女的基线血压水平，而空腹血糖受损、高血压家族史和SF-36身体评分仅在女性中与高血压显著相关。多变量调整后，SF-36身体评分[单位变化的比值比（OR）为0.97，0.94 - 0.99]仍然是仅女性高血压的显著预测指标，独立于年龄、人体测量学、基线收缩压水平、行为危险因素和其他协变量。
HRQL指标可能是高血压风险的独立预测指标，至少在女性中如此，超出了年龄、人体测量学和遗传易感性等传统危险因素的作用。
