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理想心血管健康与高血压发病:基于社区的开滦纵向研究。

Ideal cardiovascular health and incident hypertension: The longitudinal community-based Kailuan study.

作者信息

Zhao Hai Yan, Liu Xiao Xue, Wang An Xin, Wu Yun Tao, Zheng Xiao Ming, Zhao Xiao Hong, Cui Kai, Ruan Chun Yu, Lu Cheng Zhi, Jonas Jost B, Wu Shou Ling

机构信息

Department of Cardiology, Tianjin First Center Hospital, Clinical Medical College of Tianjin Medical University, Tianjin Department of Cardiology, Kailuan Hospital Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan Department of Neurology, Beijing Tiantan Hospital Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.

出版信息

Medicine (Baltimore). 2016 Dec;95(50):e5415. doi: 10.1097/MD.0000000000005415.

Abstract

Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the absence of disease and presence of 7 key health factors. Since it is unknown whether cumulative exposure to CVH reduces the risk of developing arterial hypertension, we prospectively examined the potential association between cumulative CVH (cumCVH) score (except for blood pressure metrics) and incident hypertension.Of the 101,510 participants with an age range of 18 to 98 years in this longitudinal community-based Kailuan study, our cohort included those 15,014 participants without hypertension at baseline and who had follow-up examinations 2, 4, and 6 years later. CumCVH was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (points × year). Based on the cumCVH score, the study population was stratified into groups of <44 points, 44 to 48 points, 49 to 54 points, 55 to 59 points, and ≥60 points.Incidence of hypertension ranged from 16.76% in the lowest cumCVH category to 11.52% in the highest cumCVH category. After adjusting for age, sex, education level, income level, high-sensitivity C-reactive protein concentration, uric acid concentration, resting heart rate, parental history of hypertension at baseline, and medication usage before the third follow-up examination, participants in the highest cumCVH category had a significantly reduced risk of incident hypertension compared with those in the lowest cumCVH category (adjusted odds ratio 0.60, 95% confidence interval 0.50-0.71). For every increase in category based on the cumCVH score, the risk of hypertension decreased by approximately 2% (odds ratio 0.98, 95% confidence interval 0.97-0.98). The effect was consistent across sex and age groups.A higher cumCVH score is associated with a lower risk of incident hypertension.

摘要

美国心脏协会将理想心血管健康(CVH)定义为无疾病且具备7个关键健康因素。由于累积的CVH暴露是否会降低动脉高血压的发病风险尚不清楚,我们前瞻性地研究了累积CVH(cumCVH)评分(血压指标除外)与高血压发病之间的潜在关联。在这项基于社区的开滦纵向研究中,年龄在18至98岁之间的101,510名参与者中,我们的队列包括15,014名基线时无高血压且在2年、4年和6年后接受随访检查的参与者。CumCVH通过每次检查的CVH评分总和乘以两次检查之间的时间(分数×年)来计算。根据cumCVH评分,研究人群被分为<44分、44至48分、49至54分、55至59分和≥60分几组。高血压发病率从cumCVH最低类别中的16.76%到cumCVH最高类别中的11.52%不等。在对年龄、性别、教育水平、收入水平、高敏C反应蛋白浓度、尿酸浓度、静息心率、基线时父母高血压病史以及第三次随访检查前的药物使用情况进行调整后,cumCVH最高类别的参与者与cumCVH最低类别的参与者相比,高血压发病风险显著降低(调整后的优势比为0.60,95%置信区间为0.50 - 0.71)。基于cumCVH评分,每增加一个类别,高血压风险大约降低2%(优势比为0.98,95%置信区间为0.

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