Sun H, Zheng M, Wu S, Chen M, Cai J, Yang X
Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, China.
Department of Cardiology, Kailuan Hospital, Tangshan, China.
Herz. 2017 Nov;42(7):677-683. doi: 10.1007/s00059-016-4501-x. Epub 2016 Dec 7.
The Kailuan Study examined cardiovascular risk factors in a Chinese cohort comprising employees of the Kailuan Coal Group who underwent regular health examinations.
Normotensive participants in the Kailuan study were enrolled in the present work and followed up for a median of 5.8 years to assess the development of hypertension (systolic blood pressure [SBP] ≥140 mmHg, diastolic blood pressure [DBP] ≥90 mmHg, or initiation of blood pressure [BP] medications).
This study comprised a total of 50,024 participants (age, 47.9 ± 12.0 years; male/female, 37,429/12,595), of whom 22,176 (44.3%) developed hypertension. In both male and female subjects, there was an increase in multivariable-adjusted hazard ratios for hypertension in all waist circumference (WC) groups (group 1, <70 cm; group 2, 70-79 cm; group 3, 80-89 cm; group 4, 90-99 cm; group 5, ≥100 cm). Results of a stratified analysis of subjects with normal body mass index (BMI; <24 kg/m) showed that hazard ratios for hypertension still increased across WC groups. Significant interactions were found between WC groups and gender (p <0.001), as well as between WC groups and BP categories (p <0.001). Increased WC was associated with a significantly higher risk of hypertension incidence in men compared with women and in subjects with a high-normal BP vs. those with an ideal BP.
WC is an independent predictor of hypertension incidence. The association between WC and hypertension incidence is affected by gender and baseline BP levels.
开滦研究在中国一个队列中对心血管危险因素进行了研究,该队列由开滦煤矿集团接受定期健康检查的员工组成。
选取开滦研究中的血压正常参与者纳入本研究,并进行了中位时间为5.8年的随访,以评估高血压(收缩压[SBP]≥140 mmHg、舒张压[DBP]≥90 mmHg或开始使用降压药物)的发生情况。
本研究共纳入50024名参与者(年龄47.9±12.0岁;男性/女性,37429/12595),其中22176名(44.3%)发生了高血压。在男性和女性受试者中,所有腰围(WC)组(第1组,<70 cm;第2组,70 - 79 cm;第3组,80 - 89 cm;第4组,90 - 99 cm;第5组,≥100 cm)的高血压多变量调整风险比均升高。对体重指数正常(BMI;<24 kg/m)的受试者进行分层分析的结果显示,各WC组的高血压风险比仍呈上升趋势。发现WC组与性别之间(p<0.001)以及WC组与血压类别之间存在显著交互作用(p<0.001)。与女性相比,男性以及与理想血压者相比,血压正常高值者的WC增加与高血压发病风险显著更高相关。
WC是高血压发病的独立预测因素。WC与高血压发病之间的关联受性别和基线血压水平的影响。