Chen Xiaojing, Barywani Salim Bary, Hansson Per-Olof, Rosengren Annika, Thunström Erik, Zhong You, Ergatoudes Constantinos, Mandalenakis Zacharias, Caidahl Kenneth, Fu Michael
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Medicine (Baltimore). 2020 Apr;99(17):e19895. doi: 10.1097/MD.0000000000019895.
The relationship between various categories of blood pressure (BP), subtypes of hypertension, and development of cardiovascular disease (CVD) have not been extensively studied. Therefore, our study aimed to explore this relationship in a random population sample of men born in 1943, living in Sweden and followed over a 21-year period.Participants were examined for the first time in 1993 (age 50 years), where data on medical history, concomitant diseases, and general health were collected. The examination was repeated in 2003 and with additional echocardiography also in 2014. Classification of participants according to their BP at the age of 50 years was as follows: optimal-normal BP (systolic blood pressure [SBP] <130 and diastolic BP [DBP] <85 mmHg), high-normal BP (130 ≤ SBP < 140, 85 ≤ DBP < 90 mmHg), isolated systolic-diastolic hypertension (ISH-IDH) (SBP ≥140 and DBP <90 or SBP <140 and DBP ≥90 mmHg), and systolic-diastolic hypertension (SDH) (SBP ≥140 and DBP ≥90 mmHg).During the follow-up, the incidence of heart failure (HF), CVD, and coronary heart disease were all lowest for those with optimal-normal BP. Participants with high-normal BP showed greater wall thickness and left ventricular mass index, larger LV size and larger left atrial size when compared with the optimal-normal BP group. Furthermore, those with high-normal BP, ISH-IDH, and SDH had a higher risk of CVD than those with optimal-normal BP. The adjusted relative risk of CVD was highest for SDH (hazard ratio [HR] 1.95; 95% confidence interval [95% CI] 1.37-2.79), followed by ISH-IDH (HR 1.34; 95% CI 0.93-1.95) and high-normal BP (HR 1.31; 95% CI 0.91-1.89).Over a 21-year follow-up, the participants with high-normal BP or ISH-IDH had a higher relative risk of CVD than those with optimal-normal BP.
各类血压（BP）、高血压亚型与心血管疾病（CVD）发展之间的关系尚未得到广泛研究。因此，我们的研究旨在对1943年出生、居住在瑞典且随访21年的男性随机人群样本中探究这种关系。参与者于1993年首次接受检查（年龄50岁），收集了病史、伴发疾病和一般健康状况的数据。2003年重复进行了检查，2014年还增加了超声心动图检查。根据参与者50岁时的血压进行分类如下：最佳正常血压（收缩压[SBP]<130且舒张压[DBP]<85mmHg）、高正常血压（130≤SBP<140，85≤DBP<90mmHg）、单纯收缩期-舒张期高血压（ISH-IDH）（SBP≥140且DBP<90或SBP<140且DBP≥90mmHg）以及收缩期-舒张期高血压（SDH）（SBP≥140且DBP≥90mmHg）。在随访期间，最佳正常血压者的心力衰竭（HF）、CVD和冠心病发病率均最低。与最佳正常血压组相比，高正常血压参与者的壁厚和左心室质量指数更大，左心室大小和左心房大小更大。此外，高正常血压、ISH-IDH和SDH者患CVD的风险高于最佳正常血压者。SDH的CVD调整后相对风险最高（风险比[HR]1.95；95%置信区间[95%CI]1.37 - 2.79），其次是ISH-IDH（HR 1.34；95%CI 0.93 - 1.95）和高正常血压（HR 1.31；95%CI 0.91 - 1.89）。在21年的随访中，高正常血压或ISH-IDH参与者患CVD的相对风险高于最佳正常血压者。
