Liu Feng-Di, Shen Xiao-Lei, Zhao Rong, Tao Xiao-Xiao, Wang Shuo, Zhou Jia-Jun, Zheng Bo, Zhang Qi-Ting, Yao Qian, Zhao Ying, Zhang Xin, Wang Xue-Mei, Liu Hui-Qin, Shu Liang, Liu Jian-Ren
Department of Neurology, Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
Department of Neurology, Xixi Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310023, China.
Clin Res Cardiol. 2016 Aug;105(8):677-686. doi: 10.1007/s00392-016-0972-2. Epub 2016 Feb 22.
Recent evidence suggests that pulse pressure (PP) is a strong cardiovascular diseases' risk factor. We systematically evaluated all relevant studies to determine whether PP can be used as an independent predictor of stroke and mortality.
A meta-analysis was performed by searching the published literature using MEDLINE, Cochrane and Google Scholar databases up to December 15, 2015. We measured the effect size expressed by hazard ratio (HR) and 95 % confidence interval (95 % CI). Eleven publications were included in the analysis. Pooled results demonstrated that 10 mmHg increase in PP was associated with increased risk of stroke occurrence (pooled HR 1.046, 95 % CI 1.025-1.068, P < 0.001). Additionally, systolic blood pressure (SBP) (pooled HR 1.053, 95 % CI 1.033-1.073, P < 0.001) and diastolic blood pressure (DPB) (pooled HR 1.056, 95 % CI 1.038-1.074, P < 0.001) were found to be significant predictors for stroke. We did not find a significant association between PP and all-cause mortality (pooled HR 1.022, 95 % CI 0.983-1.063, P = 0.270). We found SBP (pooled HR 1.008, 95 % CI 1.002-1.014, P = 0.012), but not DBP (pooled HR 1.023, 95 % CI 0.964-1.085, P = 0.451) to be significantly associated with all-cause mortality.
Current data confirms that PP is an independent risk factor for stroke but is not a predictor of mortality.
近期证据表明脉压（PP）是心血管疾病的一个重要危险因素。我们系统评估了所有相关研究，以确定PP是否可作为中风和死亡率的独立预测指标。
通过检索MEDLINE、Cochrane和谷歌学术数据库中截至2015年12月15日发表的文献进行荟萃分析。我们测量了以风险比（HR）和95%置信区间（95%CI）表示的效应量。分析纳入了11篇出版物。汇总结果表明，PP升高10mmHg与中风发生风险增加相关（汇总HR 1.046，95%CI 1.025 - 1.068，P < 0.001）。此外，收缩压（SBP）（汇总HR 1.053，95%CI 1.033 - 1.073，P < 0.001）和舒张压（DBP）（汇总HR 1.056，95%CI 1.038 - 1.074，P < 0.001）被发现是中风的显著预测指标。我们未发现PP与全因死亡率之间存在显著关联（汇总HR 1.022，95%CI 0.983 - 1.063，P = 0.270）。我们发现SBP（汇总HR 1.008，95%CI 1.002 - 1.014，P = 0.012）与全因死亡率显著相关，但DBP（汇总HR 1.023，95%CI 0.964 - 1.085，P = 0.451）并非如此。
当前数据证实PP是中风的独立危险因素，但不是死亡率的预测指标。
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