16年血压轨迹与左心室肥厚及左心房增大的发展：韩国基因组与流行病学研究

Blood Pressure Trajectories for 16 Years and the Development of Left Ventricular Hypertrophy and Increased Left Atrial Size: The Korean Genome and Epidemiology Study.

作者信息

Kim Seong Hwan, Lee Ju-Mi, Lee Seung Ku, Shin Chol, Park Jae-Hyeong

机构信息

Department of Cardiology, Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Republic of Korea.

Department of Preventive Medicine, Eulji College of Medicine, Daejeon, Republic of Korea.

出版信息

Int J Hypertens. 2022 Jul 18;2022:6750317. doi: 10.1155/2022/6750317. eCollection 2022.

DOI:10.1155/2022/6750317

PMID:35898962

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9313986/

Abstract

BACKGROUND

Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between the BP trajectories and the presence of LVH and LAE.

METHODS

We analyzed a total of 2,565 participants (1,267 males, 47.8 ± 6.7 years old) from the first biennial examination (2001-2002) of the Korean Genome and Epidemiology Study. The presence of LVH and LAE was identified by echocardiography performed at the 8 biennial examination (2015-2016). Latent mixture modeling was used to identify trajectories in mid-BP ((systolic BP + diastolic BP)/2) over time. Linear logistic regression was used for assessing BP trajectories with the outcomes.

RESULTS

We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, = 536), group 2 (36.2%, = 928), group 3 (32.3%, = 828), and group 4 (highest, 10.6%, = 273). Compared with the lowest group, trajectories with elevated mid-BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 2.033 (95% CI = 1.462-2.827, < 0.001) for group 2, 3.446 (95% CI = 2.475-4.797, < 0.001) for group 3, and 4.940 (95% CI = 3.318-7.356, < 0.001) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814-1.769, = 0.358) for group 2, 1.599 (95% CI = 1.084-2.360, = 0.018) for group 3, and 1.944 (95% CI = 1.212-3.118, = 0.006) for group 4.

CONCLUSIONS

Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.

摘要

背景

单次血压测量值升高可能与高血压介导的靶器官损害的发生有关，包括左心室肥厚（LVH）和左心房扩大（LAE）。然而，血压的长期模式及其对LVH和LAE的影响尚不清楚。我们评估了血压轨迹与LVH和LAE存在之间的关联。

方法

我们分析了韩国基因组与流行病学研究第一次两年一次检查（2001 - 2002年）中的2565名参与者（1267名男性，47.8±6.7岁）。在第8次两年一次检查（2015 - 2016年）时通过超声心动图确定LVH和LAE的存在。使用潜在混合模型来识别随时间变化的平均血压（（收缩压+舒张压）/2）轨迹。使用线性逻辑回归评估血压轨迹与结局的关系。

结果

我们确定了4种不同的平均血压轨迹：第1组（最低，20.9%，n = 536），第2组（36.2%，n = 928），第3组（32.3%，n = 828）和第4组（最高，10.6%，n = 273）。与最低组相比，通过多变量调整回归模型，平均血压升高的轨迹发生LVH和LAE的比值比更大。第2组LVH的调整后比值比为2.033（95%CI = 1.462 - 2.827，P < 0.001），第3组为3.446（95%CI = 2.475 - 4.797，P < 0.001），第4组为4.940（95%CI = 3.318 - 7.356，P < 0.001）。第2组LAE的调整后比值比为1.200（95%CI = 0.814 - 1.769，P = 0.358），第3组为1.599（95%CI = $1.084 - 2.360，P = 0.018），第4组为1.944（95%CI = 1.212 - 3.118，P = 0.006）。