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高血压对不同糖代谢状态中国成年人心血管疾病事件的影响。

Effects of High Blood Pressure on Cardiovascular Disease Events Among Chinese Adults With Different Glucose Metabolism.

机构信息

Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Diabetes Care. 2018 Sep;41(9):1895-1900. doi: 10.2337/dc18-0918. Epub 2018 Jul 12.

Abstract

OBJECTIVE

To investigate cardiovascular disease (CVD) risks caused by blood pressure (BP) of 130-139/80-89 mmHg among Chinese adults with different glucose metabolism.

RESEARCH DESIGN AND METHODS

A prospective population-based cohort of 2,132 adults in Shanghai was established in 2002, and CVD information was collected during 10.9 years of follow-up. After assessing the association between BP categories and incident CVD, we analyzed the risk for CVD by blood glucose categories and BP categories combined by using multiple Cox regression analysis among 1,419 participants at follow-up.

RESULTS

The corresponding incidence of CVD per 1,000 person-years for the BP <130/80 mmHg, 130-139/80-89 mmHg, and ≥140/90 mmHg or treated groups were 3.0, 6.0, and 13.9, respectively. After adjusting for age, sex, and other factors, BP ≥140/90 mmHg was significantly associated with a higher CVD risk in general (hazard ratio 2.68 [95% CI 1.36-5.25]) and in various blood glucose categories (normoglycemia 2.59, prediabetes 3.03, diabetes mellitus [DM] 4.98). However, BP of 130-139/80-89 mmHg was significantly associated with a higher CVD risk in an estimated baseline 10-year atherosclerotic CVD (ASCVD) risk ≥10% (3.82 [1.42-9.78]) or DM (3.54 [1.05-11.88]) but not in the general population or for a baseline 10-year ASCVD risk <10%, normoglycemia, or prediabetes.

CONCLUSIONS

BP of 130-139/80-89 mmHg may result in a significantly higher CVD risk in Chinese adults with an estimated 10-year ASCVD risk ≥10% or DM but not in those with normoglycemia or prediabetes.

摘要

目的

探讨中国不同糖代谢人群中血压 130-139/80-89mmHg 导致的心血管疾病(CVD)风险。

研究设计和方法

2002 年,在上海建立了一个前瞻性的基于人群的 2132 名成年人队列,在 10.9 年的随访中收集 CVD 信息。在评估了 BP 分类与 CVD 事件发生之间的关系后,我们通过多 Cox 回归分析,在 1419 名随访参与者中分析了按血糖分类和 BP 分类结合时 CVD 的风险。

结果

BP <130/80mmHg、130-139/80-89mmHg 和≥140/90mmHg 或治疗组的每 1000 人年 CVD 发生率分别为 3.0、6.0 和 13.9。在调整年龄、性别和其他因素后,BP≥140/90mmHg 与 CVD 风险升高显著相关(危险比 2.68[95%可信区间 1.36-5.25]),并且与各种血糖分类相关(血糖正常 2.59、糖尿病前期 3.03、糖尿病 4.98)。然而,BP 为 130-139/80-89mmHg 与 ASCVD 风险估计值≥10%(3.82[1.42-9.78])或糖尿病(3.54[1.05-11.88])的患者 CVD 风险升高显著相关,但在一般人群或 ASCVD 风险估计值<10%、血糖正常或糖尿病前期的患者中则不然。

结论

BP 为 130-139/80-89mmHg 可能导致中国 ASCVD 风险估计值≥10%或糖尿病患者的 CVD 风险显著升高,但对血糖正常或糖尿病前期患者则不然。

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