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血脂谱与中国社区人群中新发高血压的风险。

Lipid profiles and the risk of new-onset hypertension in a Chinese community-based cohort.

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, China.

Department of Cardiology, Peking University First Hospital, Beijing, China.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):911-920. doi: 10.1016/j.numecd.2020.11.026. Epub 2020 Dec 5.

Abstract

BACKGROUND AND AIMS

Dyslipidemia and hypertension, key risk factors for cardiovascular disease, may share similar pathophysiological processes. A longitudinal association was reported between dyslipidemia and new-onset hypertension, but few data were published in Asian. We aimed to investigate the association of lipid profiles with new-onset hypertension in a Chinese community-based non-hypertensive cohort without lipid-lowering treatment (n = 1802).

METHODS AND RESULTS

New-onset hypertension was defined as any self-reported history of hypertension, systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg, or receiving antihypertensive medications at follow-up. Logistic regression models were used to evaluate the associations. Participants were aged 53.97 ± 7.49 years, 31.19% were men, and 64.54% with dyslipidemia. During a median of 2.30 years follow-up, the incidence of new-onset hypertension was 12.99%. Multivariate adjusted risks of new-onset hypertension increased with triglyceride increases (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.03-1.27) and high-density lipoprotein cholesterol (HDL-C) decreases (OR = 0.47, 95% CI: 0.29-0.76) for one unit. However, threshold effects were observed for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and non-HDL-C. Compared with subjects with hyperlipidemia, in those with normal concentrations of TC, LDL-C, and non-HDL-C increased risks of new-onset hypertension were observed with OR (95% CI) of 1.65 (1.10-2.46), 1.58 (1.07-2.33), and 1.57 (1.15-2.15) for one unit increasement, respectively, after adjusting for all covariates.

CONCLUSION

Higher TG and lower HDL-C increased the risk of new-onset hypertension, but for TC, LDL-C and non-HDLC, the risk of new-onset hypertension was increased only at normal concentrations in a Chinese community-based cohort.

摘要

背景和目的

血脂异常和高血压是心血管疾病的主要危险因素,它们可能具有相似的病理生理过程。有研究报道血脂异常与新发高血压之间存在纵向关联,但亚洲地区的数据较少。本研究旨在调查在中国社区非高血压人群(未接受降脂治疗)中,血脂谱与新发高血压之间的关联(n=1802)。

方法和结果

新发高血压定义为随访时任何自我报告的高血压史、收缩压≥140mmHg 或舒张压≥90mmHg,或服用降压药物。采用 logistic 回归模型评估相关性。参与者的年龄为 53.97±7.49 岁,31.19%为男性,64.54%有血脂异常。中位随访时间为 2.30 年,新发高血压的发生率为 12.99%。多变量调整后,随着甘油三酯(TG)升高(比值比 [OR]为 1.14,95%置信区间 [CI]:1.03-1.27)和高密度脂蛋白胆固醇(HDL-C)降低(OR 为 0.47,95%CI:0.29-0.76),新发高血压的风险增加。然而,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇(non-HDL-C)的风险呈阈值效应。与血脂异常患者相比,在 TC、LDL-C 和非-HDL-C 浓度正常的患者中,OR(95%CI)分别为 1.65(1.10-2.46)、1.58(1.07-2.33)和 1.57(1.15-2.15),随着 TC、LDL-C 和非-HDL-C 浓度每增加一个单位,新发高血压的风险增加,调整所有协变量后。

结论

较高的 TG 和较低的 HDL-C 增加了新发高血压的风险,但对于 TC、LDL-C 和 non-HDLC,仅在社区人群中正常浓度时,新发高血压的风险才会增加。

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