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社区居住的 80 岁以上老年人中,就诊时自动诊室血压和静息脉搏率对死亡率的预测价值:闵行研究。

Predictive value of attended automated office blood pressure and resting pulse rate for mortality in community-dwelling octogenarians: Minhang study.

机构信息

Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Xinzhuang Community Health Service Center, Shanghai, China.

出版信息

J Clin Hypertens (Greenwich). 2021 Jun;23(6):1239-1245. doi: 10.1111/jch.14251. Epub 2021 May 5.

Abstract

Systolic blood pressure (SBP) and resting pulse rate (RPR) have been linked to mortality and cardiovascular events in younger population. Till now, no studies simultaneously investigate the non-linear association of SBP and RPR with all-cause and cardiovascular mortality among population aged 80 and older. Data of 2828 eligible participants were selected from electronic health records linked attended automated office blood pressure measurement system. The dose-response relationship between the SBP, RPR, and the risk of all-cause and cardiovascular mortality was analyzed by Cox model with restricted cubic splines. During the 3.6-year follow-up, 442 deaths occurred. Comparing with the optimal SBP (117-145 mmHg), the lower (HR: 1.39, 95% CI: 1.07-1.81) and higher SBP (HR: 1.34, 95% CI: 1.08-1.65) were significantly associated with an increasing risk of all-cause mortality. The higher SBP (>144 mmHg) was associated with cardiovascular mortality, with the HR (95% CI) as 1.51 (1.07-2.12). The faster RPR showed the higher risk of all-cause (HR: 1.36, 95% CI: 1.05-1.76) and cardiovascular (HR: 1.51, 95% CI: 1.07-2.13) mortality. We found both higher SBP and faster RPR were independently associated with all-cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all-cause mortality in oldest old community-dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.

摘要

收缩压(SBP)和静息脉搏率(RPR)与年轻人群的死亡率和心血管事件有关。到目前为止,尚无研究同时调查 SBP 和 RPR 与 80 岁及以上人群全因和心血管死亡率的非线性关系。从电子健康记录中选择了 2828 名符合条件的参与者的数据,这些记录与参加自动化办公室血压测量系统相关联。使用受限立方样条 Cox 模型分析 SBP、RPR 与全因和心血管死亡率风险之间的剂量-反应关系。在 3.6 年的随访期间,发生了 442 例死亡。与最佳 SBP(117-145mmHg)相比,较低(HR:1.39,95%CI:1.07-1.81)和较高 SBP(HR:1.34,95%CI:1.08-1.65)与全因死亡率增加显著相关。较高的 SBP(>144mmHg)与心血管死亡率相关,HR(95%CI)为 1.51(1.07-2.12)。较快的 RPR 显示全因(HR:1.36,95%CI:1.05-1.76)和心血管(HR:1.51,95%CI:1.07-2.13)死亡率的风险更高。我们发现较高的 SBP 和较快的 RPR 与全因和心血管死亡率独立相关,而较低的 SBP 仅与最年长的社区居住的中国人群全因死亡率增加相关。我们的研究结果表明 SBP 和 RPR 在老年人中的预后重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8750/8678789/8965ea8f3b48/JCH-23-1239-g001.jpg

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