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.
Nutr Metab Cardiovasc Dis. 2021 Jun 30;31(7):2051-2057. doi: 10.1016/j.numecd.2021.04.004. Epub 2021 Apr 21.
Both blood pressure and C-reactive protein (CRP) are individually associated with cardiovascular mortality risk. However, the combined effect of systolic blood pressure (SBP) and CRP on coronary heart disease (CHD) and cardiovascular disease (CVD) mortality risk, has not been studied.
We evaluated the joint impact of SBP and CRP and the risk of mortality in the Kuopio Ischemic Heart Disease prospective cohort study of 1622 men aged 42-61 years at recruitment with no history of CVD. SBP and CRP were measured. SBP was categorized as low and high (cut-off 135 mmHg) and CRP as low and high (cut-off 1.54 mg/L) based on ROC curves. Multivariable adjusted hazard ratios (HRs) with confidence intervals (CI) were calculated. During a median follow-up of 28 years, 196 cases of CHD and 320 cases of CVD deaths occurred. Elevated SBP (>135 mmHg) combined with elevated (CRP >1.54 mg/L) were associated with CHD and CVD mortality (HR 3.41, 95% CI, 2.20-5.28, p < 0.001) and (HR 2.93, 95% CI, 2.11-4.06, p < 0.001) respectively after adjustment for age, examination year, smoking, alcohol consumption, BMI, Type 2 diabetes, energy expenditure, total cholesterol, serum HDL cholesterol, antihypertensive medication and use of aspirin.
The combined effect of both high systolic blood pressure and high CRP is associated with increased risk of future CHD and CVD mortality as compared with both low SBP and low CRP levels in general male Caucasian population.
血压和 C 反应蛋白（CRP）均与心血管死亡风险相关。然而，收缩压（SBP）和 CRP 对冠心病（CHD）和心血管疾病（CVD）死亡风险的联合影响尚未得到研究。
我们评估了 SBP 和 CRP 的联合影响以及 Kuopio 缺血性心脏病前瞻性队列研究中 1622 名年龄在 42-61 岁且无 CVD 病史的男性招募时的死亡率风险。测量了 SBP 和 CRP。根据 ROC 曲线，将 SBP 分为低和高（截断值 135mmHg），CRP 分为低和高（截断值 1.54mg/L）。计算了多变量调整后的危险比（HR）和置信区间（CI）。在中位随访 28 年期间，发生了 196 例 CHD 和 320 例 CVD 死亡。升高的 SBP（>135mmHg）与升高的 CRP（>1.54mg/L）联合与 CHD 和 CVD 死亡率相关（HR 3.41，95%CI，2.20-5.28，p<0.001）和（HR 2.93，95%CI，2.11-4.06，p<0.001），校正年龄、检查年份、吸烟、饮酒、BMI、2 型糖尿病、能量消耗、总胆固醇、血清高密度脂蛋白胆固醇、降压药物和使用阿司匹林后。
与一般白种男性人群中低 SBP 和低 CRP 水平相比，高收缩压和高 CRP 的联合作用与未来 CHD 和 CVD 死亡率风险增加相关。
