平均动脉压与青年人群全因和心血管死亡率的相关性。
Association of mean arterial pressure with all-cause and cardiovascular mortality in young adults.
机构信息
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou, China.
Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
出版信息
Postgrad Med J. 2020 Aug;96(1138):455-460. doi: 10.1136/postgradmedj-2019-137354. Epub 2020 May 13.
BACKGROUND
Mean arterial pressure (MAP) is a predictor of all-cause and cardiovascular disease (CVD) mortality in middle-aged population and elderly, but less evidence has been shown in young adults.
OBJECTIVES
We examined the associations of MAP with all-cause and CVD mortality in young adults aged between 18 and 40 years.
METHODS
Data were from the National Health and Nutrition Examination Survey (1999-2006) and participants were followed up to 31 December 2015. MAP was categorised by quartiles. Multivariable Cox proportional hazards models and Kaplan-Meier survival curves were performed to estimate the association between MAP, all-cause and CVD mortality.
RESULTS
There were a total of 8356 (4598 women (55.03%)) participants with the mean age of 26.63±7.01 years, of which 265 (3.17%) and 10 (0.12%) cases of all-cause and cardiovascular mortality occurred during a median follow-up duration of 152.96±30.45 months, respectively. There was no significant difference in the survival rate by MAP quartiles (p=0.058). When MAP was treated as a continuous variable, the multivariable adjusted HRs for all-cause and CVD mortality were 1.00 (95% CI 0.96 to 1.04; p=0.910) and 0.94 (95% CI 0.77 to 1.14; p=0.529), respectively. When using the lowest quartile (Q1) as referent, the adjusted HRs for all-cause mortality from Q2 to Q4 were 1.16 (95% CI 0.56 to 2.42), 1.06 (95% CI 0.48 to 2.32) and 0.91 (95% CI 0.37 to 2.24; p for tend was 0.749) after adjusting for potential confounders.
CONCLUSION
There was no significant association of MAP with all-cause and CVD mortality in young adults with a relatively short follow-up time.
背景
平均动脉压（MAP）是中年和老年人群全因和心血管疾病（CVD）死亡率的预测指标，但在年轻人中证据较少。
目的
我们研究了 MAP 与 18 至 40 岁年轻人全因和 CVD 死亡率之间的关系。
方法
数据来自国家健康和营养检查调查（1999-2006 年），参与者随访至 2015 年 12 月 31 日。MAP 按四分位数分类。使用多变量 Cox 比例风险模型和 Kaplan-Meier 生存曲线来估计 MAP 与全因和 CVD 死亡率之间的关联。
结果
共有 8356 名（4598 名女性（55.03%））参与者，平均年龄为 26.63±7.01 岁，中位随访时间为 152.96±30.45 个月，期间分别有 265（3.17%）和 10（0.12%）例全因和心血管死亡。MAP 四分位组之间的生存率无显著差异（p=0.058）。当 MAP 作为连续变量处理时，全因和 CVD 死亡率的多变量调整 HR 分别为 1.00（95%CI 0.96 至 1.04；p=0.910）和 0.94（95%CI 0.77 至 1.14；p=0.529）。以最低四分位（Q1）为参考，Q2 至 Q4 的全因死亡率调整 HR 分别为 1.16（95%CI 0.56 至 2.42）、1.06（95%CI 0.48 至 2.32）和 0.91（95%CI 0.37 至 2.24；p 趋势为 0.749），在调整潜在混杂因素后。
结论
在随访时间相对较短的年轻人中，MAP 与全因和 CVD 死亡率无显著关联。
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