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慢性阻塞性肺疾病与男性高血压独立相关:一项使用全国性调查数据的调查设计分析。

Chronic obstructive pulmonary disease is independently associated with hypertension in men: A survey design analysis using nationwide survey data.

作者信息

Kim Seon-Hye, Park Ju-Hee, Lee Jung-Kyu, Heo Eun Young, Kim Deog Kyeom, Chung Hee Soon

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital Division of Pulmonary and Critical Care Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

Medicine (Baltimore). 2017 May;96(19):e6826. doi: 10.1097/MD.0000000000006826.

Abstract

Although studies have shown that chronic obstructive pulmonary disease (COPD) and hypertension are linked as comorbidities, it remains unclear whether COPD is independently associated with the risk of hypertension or is caused by common risk factors such as age and smoking. The objective of this study was to investigate the relationship between COPD and hypertension by using nationally representative data.This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey V conducted during 2010 to 2012. Hypertension was defined as a mean systolic blood pressure ≥ 140 mm Hg and/or a diastolic blood pressure ≥ 90 mm Hg, or current consumption of antihypertensive medications. A diagnosis of COPD was defined as a smoking history of at least 10 pack-years with airflow limitation on spirometry. Multivariate logistic regression was performed to investigate the independent association between COPD and hypertension after adjusting for covariates. Survey design analyses were conducted for all analyses.Among 4043 men (aged ≥ 40 years) who underwent spirometry, 2190 (54.2%) had hypertension. Even after adjusting for age, body mass index, smoking status, diabetes, metabolic syndrome, and stroke, COPD was independently associated with hypertension (adjusted odds ratio, 1.71; 95% confidence interval, 1.37-2.13; P < .001). Adjusted pulse pressure significantly increased as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity and FEV1 decreased.COPD is independently associated with hypertension, and this could explain the link between the risk of cardiovascular diseases and COPD.

摘要

尽管研究表明慢性阻塞性肺疾病(COPD)和高血压作为合并症存在关联,但COPD是独立与高血压风险相关,还是由年龄和吸烟等共同风险因素引起,仍不清楚。本研究的目的是利用全国代表性数据调查COPD与高血压之间的关系。这项横断面研究分析了2010年至2012年期间进行的韩国国家健康与营养检查调查V的数据。高血压定义为平均收缩压≥140mmHg和/或舒张压≥90mmHg,或目前正在服用抗高血压药物。COPD的诊断定义为吸烟史至少10包年且肺活量测定存在气流受限。在调整协变量后,进行多变量逻辑回归以研究COPD与高血压之间的独立关联。所有分析均进行了调查设计分析。在4043名接受肺活量测定的男性(年龄≥40岁)中,2190名(54.2%)患有高血压。即使在调整了年龄、体重指数、吸烟状况、糖尿病、代谢综合征和中风后,COPD仍与高血压独立相关(调整后的优势比为1.71;95%置信区间为1.37 - 2.13;P<0.001)。随着1秒用力呼气量(FEV1)与用力肺活量的比值以及FEV1降低,调整后的脉压显著增加。COPD与高血压独立相关,这可以解释心血管疾病风险与COPD之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6300/5428594/d3fde8c8a571/medi-96-e6826-g001.jpg

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