血压和 C 反应蛋白的联合作用与心源性猝死风险：一项前瞻性队列研究。
Joint effect of blood pressure and C-reactive protein and the risk of sudden cardiac death: A prospective cohort study.
机构信息
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio. Finland.
Department of Sport Science, University of Seoul, Seoul, Republic of Korea; Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea.
出版信息
Int J Cardiol. 2021 Mar 1;326:184-188. doi: 10.1016/j.ijcard.2020.10.071. Epub 2020 Oct 30.
BACKGROUND
Both blood pressure and C-reactive protein (CRP) are each independently related to mortality risk. However, the combined effect of systolic blood pressure (SBP) and CRP on sudden cardiac death (SCD) risk has not been studied.
PATIENTS AND METHODS
We studied the joint impact of SBP and CRP and the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 1953 men aged 42-61 years with no history of ischemic heart disease. Baseline investigations were conducted between March 1984 and December 1989. SBP and CRP were measured. SBP was divided based on median values to low and high (median cutoffs 132 mmHg) and CRP as low and high (median cut-off 1.30 mg/L). Hazard ratios (HRs) with confidence intervals (CIs) were calculated after multivariate adjustment.
RESULTS
Subjects were followed-up for 23.2 years, and 137 SCDs occurred. In this study, elevated SBP (>132 mmHg) combined with elevated (CRP >1.30 mg/L) were associated with SCD risk. Adjustment for age, examination year, alcohol consumption, BMI, energy expenditure during exercise, total cholesterol, HDL-cholesterol, type 2 diabetes, smoking, antihypertension medication and aspirin use, the risk of SCD remained statistically significant (HR, 2,73, 95% CI, 1.62-4.60, p < .001). Further adjustment for socio-economic status, years of education and history of cardiovascular disease in a family the results were only slightly changed (HR, 2.65, 95% CI, 1.57-4.49, p < .001).
CONCLUSIONS
In our male cohort study, the joint effect of high SBP together with increased CRP levels is a risk predictor of SCD compared with low SBP and CRP.
背景
血压和 C 反应蛋白（CRP）均与死亡率独立相关。然而，收缩压（SBP）和 CRP 联合对心脏性猝死（SCD）风险的影响尚未研究。
患者和方法
我们研究了 SBP 和 CRP 的联合作用以及在没有缺血性心脏病史的 1953 名年龄在 42-61 岁的男性的库奥皮奥缺血性心脏病前瞻性队列研究中的 SCD 风险。基线研究于 1984 年 3 月至 1989 年 12 月进行。测量 SBP 和 CRP。根据中位数将 SBP 分为低和高（中位数截止值 132mmHg），CRP 分为低和高（中位数截止值 1.30mg/L）。经过多变量调整后，计算危险比（HRs）和置信区间（CIs）。
结果
受试者随访 23.2 年，发生 137 例 SCD。在这项研究中，升高的 SBP（>132mmHg）与升高的 CRP（>1.30mg/L）联合与 SCD 风险相关。调整年龄、检查年份、饮酒、BMI、运动期间的能量消耗、总胆固醇、高密度脂蛋白胆固醇、2 型糖尿病、吸烟、降压药物和阿司匹林使用后，SCD 的风险仍然具有统计学意义（HR，2.73，95%CI，1.62-4.60，p<0.001）。进一步调整社会经济地位、受教育年限和家族心血管疾病史后，结果仅略有变化（HR，2.65，95%CI，1.57-4.49，p<0.001）。
结论
在我们的男性队列研究中，与低 SBP 和 CRP 相比，高 SBP 与 CRP 水平升高的联合作用是 SCD 的风险预测指标。
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