脉压并非60岁男性和女性发生心房颤动的独立预测因素。
Pulse pressure is not an independent predictor of incident atrial fibrillation in 60-year-old men and women.
作者信息
Miedel Charlotte, Leander Karin, de Faire Ulf, Gigante Bruna
机构信息
a Unit of Cardiovascular Epidemiology , Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden.
b Department of Cardiology , Karolinska University Hospital , Stockholm , Sweden.
出版信息
Ann Med. 2015;47(8):679-86. doi: 10.3109/07853890.2015.1100321. Epub 2015 Nov 9.
AIM
To evaluate if pulse pressure (PP) is a risk predictor for atrial fibrillation (AF) in a longitudinal study of 60-year-old men and women from Stockholm (n = 4,232), free from AF at baseline, with primary end-point incident AF.
METHODS
AF diagnoses were obtained from the national hospital discharge register. The estimated risk of AF associated with increasing PP values was calculated according to PP values above median (>52.5 mmHg) and according to 1-SD increase (14 mmHg) in PP, using a crude and an adjusted Cox proportional hazard regression model.
RESULTS
During a mean follow-up of 13.6 years, 286 incident AF cases were recorded. The number of AF cases increased significantly with increasing PP quartile in men but not in women. PP values above median were associated with increased AF risk (crude HR 1.63, 95% CI 1.28-2.06; p < 0.001), but risk estimates were attenuated after adjustment for common AF risk factors. When PP was entered in the Cox regression model as a continuous variable, the risk of AF did not change by 1-SD PP increase (adjusted HR 1.04, 95% CI 0.91-1.20; p = 0.560).
CONCLUSIONS
PP seems not to be associated with incident AF in a Swedish population of 60-year-old men and women.
目的
在一项针对来自斯德哥尔摩的60岁男性和女性（n = 4232）的纵向研究中，评估脉压（PP）是否为心房颤动（AF）的风险预测因素，这些研究对象在基线时无AF，主要终点为新发AF。
方法
从国家医院出院登记处获取AF诊断信息。使用粗Cox比例风险回归模型和校正后的Cox比例风险回归模型，根据PP值高于中位数（>52.5 mmHg）以及PP值每增加1个标准差（14 mmHg），计算与PP值升高相关的AF估计风险。
结果
在平均13.6年的随访期间，记录了286例新发AF病例。男性中AF病例数随PP四分位数增加而显著增加，女性则不然。PP值高于中位数与AF风险增加相关（粗风险比1.63，95%置信区间1.28 - 2.06；p < 0.001），但在对常见AF风险因素进行校正后，风险估计值减弱。当将PP作为连续变量纳入Cox回归模型时，PP每增加1个标准差，AF风险无变化（校正风险比1.04，95%置信区间0.91 - 1.20；p = 0.560）。
结论
在瑞典60岁的男性和女性人群中，PP似乎与新发AF无关。
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