Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.
PLoS One. 2020 Oct 21;15(10):e0240804. doi: 10.1371/journal.pone.0240804. eCollection 2020.
The patterns of blood pressure trajectory (i.e., change over time) over life-course remain to be explored. In this study, we aim to determine the trajectories of systolic blood pressure (SBP) from adulthood to late life and to assess its impact on the risk of cardiovascular diseases (CVDs).
Based on the China Health and Nutrition Survey, a total of 3566 participants aged 20-50 years at baseline (1989) with at least three SBP measurements during 1989-2011 were included. SBP was measured through physical examination, and socio-demographic factors, lifestyles, medications, and CVDs were based on self-reported questionnaire. Latent class growth modeling was performed to examine SBP trajectory. Odds ratio (OR) and 95% confidence interval (CI) from logistic regression was used to determine the association between SBP trajectory and CVDs.
Five trajectory groups of SBP were identified: Class 1: rapid increase (n = 113, 3.2%); Class 2: slight increase (n = 1958, 54.9%); Class 3: stable (n = 614, 17.2%); Class 4: increase (n = 800, 22.4%); Class 5: fluctuant (n = 81, 2.3%). After adjustment of demographic factors, baseline SBP, and lifestyles, compared with the "slight increase" group, the OR (95% CI) of CVDs was 0.65 (0.32, 1.28) for "stable" group, 2.24 (1.40, 3.58) for "increase" group, 3.95 (1.81, 8.62) for "rapid increase" group, and 4.32 (1.76, 10.57) for "fluctuant" group. After stratified by use of antihypertensive drugs, the association was only significant for "rapid increase" group among those using antihypertensive drugs with OR (95% CI) of 2.81 (1.01, 7.77).
Having a rapidly increasing SBP over life-course is associated with a higher risk of CVDs. This implies the importance of monitoring lifetime change of blood pressure for the prevention of CVDs.
血压轨迹（即随时间的变化）模式仍有待探索。本研究旨在确定从成年到老年期间收缩压（SBP）的轨迹，并评估其对心血管疾病（CVDs）风险的影响。
基于中国健康与营养调查，共纳入了 3566 名基线时（1989 年）年龄在 20-50 岁之间且在 1989-2011 年期间至少有三次 SBP 测量值的参与者。SBP 通过体检测量，社会人口统计学因素、生活方式、药物和 CVDs 基于自我报告的问卷调查。采用潜在类别增长模型来检查 SBP 轨迹。采用逻辑回归的比值比（OR）和 95%置信区间（CI）来确定 SBP 轨迹与 CVDs 之间的关联。
确定了 SBP 的五个轨迹组：第 1 类：快速增加（n=113，3.2%）；第 2 类：略有增加（n=1958，54.9%）；第 3 类：稳定（n=614，17.2%）；第 4 类：增加（n=800，22.4%）；第 5 类：波动（n=81，2.3%）。在调整人口统计学因素、基线 SBP 和生活方式后，与“略有增加”组相比，“稳定”组 CVDs 的 OR（95%CI）为 0.65（0.32，1.28），“增加”组为 2.24（1.40，3.58），“快速增加”组为 3.95（1.81，8.62），“波动”组为 4.32（1.76，10.57）。在按使用降压药物分层后，仅在使用降压药物的“快速增加”组中，OR（95%CI）为 2.81（1.01，7.77），具有统计学意义。
一生中 SBP 快速增加与 CVDs 风险增加相关。这意味着监测血压的终生变化对于预防 CVDs 非常重要。
