Divisions of Hypertension and Heart Failure.
Department of Biostatistics, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.
J Hypertens. 2018 Jan;36(1):93-100. doi: 10.1097/HJH.0000000000001528.
To compare the risk of stroke and coronary heart disease (CHD) among various blood pressure (BP) levels in diabetic and people without diabetes Chinese patients.
This cross-sectional study was part of Prospective Urban Rural Epidemiology China study. Patients aged 35 to70 years were recruited from 12 provinces of China between 2005 and 2009. The participants were classified into three groups: hypertension (HTN), high normal BP, and normal BP, and also into SBP and DBP quintiles.
A total of 42 959 patients were analyzed with 38 975 (90.7% of total population) people without diabetes and 3984 (9.3% of total population) diabetic patients. Among diabetic patients, the HTN group was associated with an increased risk of stroke (odds ratio, 3.03; 95% confidence interval, 1.47-6.25) and CHD (odds ratio, 2.21; 95% confidence interval, 1.45-3.38), when compared with normal BP group. Similar results were drawn in nondiabetic patients. However, no significant difference in risk of stroke or CHD was found between high normal BP and normal BP groups in either diabetic or nondiabetic patients. Risk of CHD and stroke increased significantly when SBP was above 125 mmHg or DBP above 72 mmHg in people without diabetes, whereas this trend was attenuated in diabetic patients.
HTN was associated with a two-fold increased risk of CHD and a three-fold increased risk of stroke compared with normotension irrespective of diabetes status. For diabetic patients with HTN, a more comprehensive method is essential for assessing cardiovascular risk.
比较中国糖尿病患者和非糖尿病患者不同血压（BP）水平发生卒中及冠心病（CHD）的风险。
这是一项横断面研究，是中国前瞻性城乡流行病学研究的一部分。研究于 2005 年至 2009 年在全国 12 个省招募了年龄在 35 至 70 岁之间的患者。参与者被分为三组：高血压（HTN）、血压高值和正常血压，并分为收缩压（SBP）和舒张压（DBP）五分位数。
共分析了 42959 名患者，其中 38975 名（占总人群的 90.7%）无糖尿病，3984 名（占总人群的 9.3%）为糖尿病患者。在糖尿病患者中，与正常血压组相比，HTN 组卒中（优势比 [OR]，3.03；95%置信区间 [CI]，1.47-6.25）和 CHD（OR，2.21；95%CI，1.45-3.38）的风险增加。在非糖尿病患者中也得到了类似的结果。然而，无论在糖尿病患者还是非糖尿病患者中，血压高值与正常血压组之间的卒中或 CHD 风险均无显著差异。在非糖尿病患者中，当 SBP 超过 125mmHg 或 DBP 超过 72mmHg 时，CHD 和卒中的风险显著增加，而在糖尿病患者中，这种趋势则减弱。
与血压正常者相比，HTN 与 CHD 和卒中的风险增加两倍相关，而与糖尿病状态无关。对于患有 HTN 的糖尿病患者，需要采用更全面的方法评估心血管风险。
