Department of Clinical Science, University of Bergen, PO Box 7804, 5020 Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway.
Eur J Prev Cardiol. 2022 Feb 19;29(1):147-154. doi: 10.1093/eurjpc/zwab068.
Hypertension has been suggested as a stronger risk factor for acute coronary syndromes (ACS) in women than men. Whether this also applies to stage 1 hypertension [blood pressure (BP) 130-139/80-89 mmHg] is not known.
We tested associations of stage 1 hypertension with ACS in 12 329 participants in the Hordaland Health Study (mean baseline age 41 years, 52% women). Participants were grouped by baseline BP category: Normotension (BP < 130/80 mmHg), stage 1 and stage 2 hypertension (BP ≥140/90 mmHg). ACS was defined as hospitalization or death due to myocardial infarction or unstable angina pectoris during 16 years of follow-up. At baseline, a lower proportion of women than men had stage 1 and 2 hypertension, respectively (25 vs. 35% and 14 vs. 31%, P < 0.001). During follow-up, 1.4% of women and 5.7% of men experienced incident ACS (P < 0.001). Adjusted for diabetes, smoking, body mass index, cholesterol, and physical activity, stage 1 hypertension was associated with higher risk of ACS in women [hazard ratio (HR) 2.18, 95% confidence interval (CI) 1.32-3.60], while the association was non-significant in men (HR 1.30, 95% CI 0.98-1.71). After additional adjustment for systolic and diastolic BP, respectively, stage 1 diastolic hypertension was associated with ACS in women (HR 2.79 [95% CI 1.62-4.82]), but not in men (HR 1.24 [95% CI 0.95-1.62]), while stage 1 systolic hypertension was not associated with ACS in either sex.
Among subjects in their early 40s, stage 1 hypertension was a stronger risk factor for ACS during midlife in women than in men.
高血压被认为是女性发生急性冠脉综合征（ACS）的风险因素强于男性。但尚不清楚这一情况是否同样适用于 1 期高血压[血压（BP）130-139/80-89mmHg]。
我们在参加霍达兰健康研究（基线年龄平均为 41 岁，52%为女性）的 12329 名参与者中检验了 1 期高血压与 ACS 的相关性。根据基线 BP 类别对参与者进行分组：正常血压（BP<130/80mmHg）、1 期高血压和 2 期高血压（BP≥140/90mmHg）。ACS 定义为在 16 年的随访期间因心肌梗死或不稳定型心绞痛住院或死亡。基线时，女性中 1 期和 2 期高血压的比例均低于男性（分别为 25%和 35%，14%和 31%，P<0.001）。在随访期间，1.4%的女性和 5.7%的男性发生 ACS（P<0.001）。经糖尿病、吸烟、体重指数、胆固醇和体力活动调整后，1 期高血压与女性 ACS 风险增加相关[危险比（HR）2.18，95%置信区间（CI）1.32-3.60]，而在男性中则无显著相关性（HR 1.30，95% CI 0.98-1.71）。分别进一步调整收缩压和舒张压后，1 期舒张期高血压与女性 ACS 相关（HR 2.79[95% CI 1.62-4.82]），但与男性无关（HR 1.24[95% CI 0.95-1.62]），而 1 期收缩期高血压与两性的 ACS 均无关。
在 40 岁出头的人群中，1 期高血压是女性中年时期发生 ACS 的更强危险因素，而在男性中则不然。
