Chen Yen-Lin, Hsu Chun-Hsien, Hsieh Chang-Hsun, Wu Chung-Ze, Lin Jiunn-Diann, Chang Jin-Biou, Liang Yao-Jen, Tsai Yi-Ting, Hsia Te-Lin, Pei Dee
Department of Pathology, Cardinal Tien Hospital, School of Medicine, College of Medicine, Fu-Jen Catholic University Division of Molecular Pathology, Department of Pathology, Cardinal Tien Hospital Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City Department of Internal Medicine, Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City Department of Pathology, National Defense Medical Center, Division of Clinical Pathology, Tri-Service General Hospital, Taipei College of Science and Engineering, Institute of Applied Science and Engineering, Department and Institute of Life-Science Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
Medicine (Baltimore). 2017 Jun;96(25):e7227. doi: 10.1097/MD.0000000000007227.
Hypertension and prehypertension can increase the risk of developing cardiovascular disease (CVD) and diabetes. However, whether the harmful effects of high blood pressure (BP) are also seen with high normotension remains unknown. This 10-year longitudinal follow-up study aimed to investigate the relationships among normal-range BP, metabolic syndrome (MetS), and CVD.A total of 9133 nonmedicated normotensive participants, 4634 males and 4499 females, aged 60 years or older were enrolled in a standard health examination program at 2 academic hospitals and a health screening center in Taiwan. The study subjects were divided into 3 groups according to their BP. The systolic BP (SBP) ranges of groups 1, 2, and 3 were 91 to 100, 101 to 110, and 111 to 119 mmHg, whereas the diastolic BP (DBP) ranges of groups 1, 2, and 3 were 51 to 60, 61 to 70, and 71 to 79 mmHg, respectively.In the SBP3 group, both sexes had a higher odds ratio (OR) for having MetS or abnormal MetS components, except for triglycerides. Females in the DBP3 group had a higher OR for having MetS at baseline. After the follow-up period, the SBP3 group had a significantly higher hazard ratio (HR) for developing MetS. Males in the DBP3 group and females in the DBP2 and DBP3 groups had a significantly higher HR for developing MetS. Neither the SBP3 group nor the DBP3 group had a higher HR for developing nonfatal CVD. In the Kaplan-Meier analysis, SBP and DBP in both sexes showed statistical significance as predictors of MetS, but not of nonfatal CVD.High normotensive elderly individuals have an elevated risk of developing MetS at baseline and within 10 years of follow-up, but they are not at increased risk of CVD. Preventive interventions, such as life-style modification, should be offered early even to the apparently healthy elderly.
高血压和高血压前期会增加患心血管疾病（CVD）和糖尿病的风险。然而，血压正常偏高是否也会产生有害影响仍不清楚。这项为期10年的纵向随访研究旨在调查正常范围血压、代谢综合征（MetS）和心血管疾病之间的关系。
共有9133名未服用药物的血压正常参与者，其中4634名男性和4499名女性，年龄在60岁及以上，他们参加了台湾两家学术医院和一个健康筛查中心的标准健康检查项目。研究对象根据血压分为3组。第1、2、3组的收缩压（SBP）范围分别为91至100、101至110和111至119mmHg，而第1、2、3组的舒张压（DBP）范围分别为51至60、61至70和71至79mmHg。
在收缩压3组中，除甘油三酯外，两性患代谢综合征或代谢综合征异常组分的比值比（OR）均较高。舒张压3组中的女性在基线时患代谢综合征的OR较高。随访期后，收缩压3组患代谢综合征的风险比（HR）显著更高。舒张压3组中的男性以及舒张压2组和3组中的女性患代谢综合征的HR显著更高。收缩压3组和舒张压3组发生非致死性心血管疾病的HR均不高。在Kaplan-Meier分析中，两性的收缩压和舒张压作为代谢综合征的预测指标具有统计学意义，但对非致死性心血管疾病则无统计学意义。
血压正常偏高的老年人在基线时以及随访10年内患代谢综合征的风险升高，但患心血管疾病的风险并未增加。即使对于看似健康的老年人，也应尽早提供诸如生活方式改变等预防性干预措施。
