Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Shanghai, China.
Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Blood Press. 2021 Jun;30(3):180-187. doi: 10.1080/08037051.2021.1889967. Epub 2021 Feb 23.
We investigated associations of blood pressure (BP) with albuminuria and left ventricular hypertrophy (LVH) in young, middle and older aged patients with hypertension and/or diabetes mellitus.
MATERIALS & METHODS: Study participants were treated patients with hypertension or diabetes, enrolled in a China nationwide registry. The 2510 patients were classified into young (<45 years, = 345), middle (45-64 years, = 1383) and older (≥65 years, = 782) age groups. Clinic BP was measured three times consecutively on each of the two clinic visits. These six readings were averaged for analyses. Albuminuria was defined as a urinary albumin-to-creatinine ratio of ≥30 mg/g. LVH was assessed by the electrocardiogram (ECG) Cornell product and voltage methods.
The prevalence of albuminuria and ECG-LVH was 17.8 and 6.5%, respectively. Mean (±SD) systolic/diastolic BP was 132.0 ± 16.5/85.2 ± 11.9 mmHg, 136.8 ± 17.9/81.7 ± 11.2 mmHg, and 139.8 ± 16.7/75.8 ± 10.4 mmHg in the young, middle and older age groups. In the young age group, the prevalence of albuminuria increased from 8.8% in systolic/diastolic BP <120/80 mmHg to 14.6, 16.0% and 16.5% in 120-129/80-84, 130-139/85-89 and ≥140/90 mmHg, respectively. The corresponding values were 8.9, 7.0, 18.1 and 22.2%, respectively, in the middle age group, and 21.2, 15.5, 16.4 and 24.4%, respectively, in the older age group. Adjusted analyses confirmed the J-shaped relation between BP and albuminuria in the older but not young age group. The prevalence of ECG-LVH was significantly ( for trend ≤0.04) higher with increasing BP similarly in all age groups.
The association between BP and organ damage seems to differ in young, middle and older aged patients for albuminuria but not ECG-LVH.
我们研究了血压（BP）与蛋白尿和左心室肥厚（LVH）在年轻、中年和老年高血压和/或糖尿病患者中的相关性。
研究参与者为在中国全国性登记处接受高血压或糖尿病治疗的患者。2510 名患者分为年轻组（<45 岁，n=345）、中年组（45-64 岁，n=1383）和老年组（≥65 岁，n=782）。在两次就诊时，连续测量诊所血压三次，将这六次读数的平均值用于分析。蛋白尿定义为尿白蛋白/肌酐比值≥30mg/g。LVH 通过心电图（ECG）Cornell 乘积和电压方法进行评估。
蛋白尿和 ECG-LVH 的患病率分别为 17.8%和 6.5%。平均（±SD）收缩压/舒张压分别为 132.0±16.5/85.2±11.9mmHg、136.8±17.9/81.7±11.2mmHg 和 139.8±16.7/75.8±10.4mmHg，分别为年轻、中年和老年组。在年轻组中，蛋白尿的患病率从收缩压/舒张压<120/80mmHg 的 8.8%增加到 120-129/80-84mmHg 的 14.6%、130-139/85-89mmHg 的 16.0%和≥140/90mmHg 的 16.5%。在中年组中，相应的数值分别为 8.9%、7.0%、18.1%和 22.2%，在老年组中，相应的数值分别为 21.2%、15.5%、16.4%和 24.4%。调整分析证实，血压与蛋白尿之间的 J 形关系仅在老年组而非年轻组中存在。心电图-LVH 的患病率随着血压的升高而显著升高（趋势 P<0.04），在所有年龄组中均如此。
血压与蛋白尿之间的关系在年轻、中年和老年患者中似乎不同，但与心电图-LVH 无关。
Zotero 插件