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中国社区高血压人群中双臂血压差异的患病率及相关因素。

Prevalence and associated factors of inter-arm blood pressure difference in Chinese community hypertensive population.

机构信息

Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, China.

Second Clinical Medical College, Southern Medical University, 510080 Guangzhou, China.

出版信息

Postgrad Med. 2021 Mar;133(2):188-194. doi: 10.1080/00325481.2020.1826184. Epub 2020 Oct 29.

Abstract

OBJECTIVES

This study aimed to investigate the prevalence and associated factors of inter-arm blood pressure difference (IAD) in Chinese community hypertensive population.

METHODS

The cross-sectional study included 7788 hypertensive patients (3673 male and 4115 female, aged 62.3 ± 13.6 years) in Guangdong, China. IAD was defined as the absolute value of blood pressure (BP) difference between left and right arms. Bilateral BP was measured simultaneously by automated devices.

RESULTS

The mean IAD was 4.04 ± 4.33 mm Hg in systolic and 3.19 ± 3.43 mm Hg in diastolic. The prevalence rates of systolic IAD (sIAD)≥5 mm Hg and ≥10 mmHg were 28.9% (n = 2247) and 12.8% (n = 996), respectively. By univariate linear regression, higher sIAD correlated with aging, higher SBP, higher DBP, lower baseline estimated glomerular filtration rate (eGFR), and anti-hypertensive medication (p < 0.05). In multivariate linear regression analysis, higher sIAD was significantly associated with systolic BP (SBP, β = 0.033; 95%CI, 0.025-0.041; p < 0.001), triacylglycerol (β = 0.093; 95%CI, 0.017-0.169; p = 0.016), total cholesterol (β = -0.202; 95%CI, -0.396to -0.009; p = 0.04), and low-density lipoprotein cholesterol (LDL-C; β = 0.304; 95%CI, 0.027-0.582; p = 0.032).

CONCLUSION

The elevated prevalence of large IAD was shown in hypertensive population. Meanwhile, higher levels of SBP, triacylglycerol, total cholesterol, LDL-C, and lower eGFR were associated with higher sIAD.

摘要

目的

本研究旨在调查中国社区高血压人群中臂间血压差异(IAD)的患病率及其相关因素。

方法

本横断面研究纳入了中国广东的 7788 名高血压患者(男 3673 名,女 4115 名,年龄 62.3±13.6 岁)。IAD 定义为左、右臂血压差值的绝对值。双侧血压由自动设备同时测量。

结果

收缩压和舒张压的平均 IAD 分别为 4.04±4.33 mm Hg 和 3.19±3.43 mm Hg。收缩压 IAD(sIAD)≥5 mm Hg 和≥10 mm Hg 的患病率分别为 28.9%(n=2247)和 12.8%(n=996)。单因素线性回归显示,较高的 sIAD 与年龄增长、较高的收缩压、较高的舒张压、较低的基础估算肾小球滤过率(eGFR)和抗高血压药物治疗相关(p<0.05)。多元线性回归分析显示,较高的 sIAD 与收缩压(SBP,β=0.033;95%CI,0.025-0.041;p<0.001)、三酰甘油(β=0.093;95%CI,0.017-0.169;p=0.016)、总胆固醇(β=-0.202;95%CI,-0.396 至 -0.009;p=0.04)和低密度脂蛋白胆固醇(LDL-C;β=0.304;95%CI,0.027-0.582;p=0.032)显著相关。

结论

高血压人群中 IAD 升高的患病率较高。同时,较高的 SBP、三酰甘油、总胆固醇、LDL-C 和较低的 eGFR 与较高的 sIAD 相关。

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