Department of Medical Research, Vestre Viken Hospital Trust, Bærum Hospital, Drammen, Norway
Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.
Open Heart. 2024 Aug 22;11(2):e002805. doi: 10.1136/openhrt-2024-002805.
American and European guidelines define hypertension differently and are sex agnostic. Our aim was to assess the impact of different hypertension thresholds at the age of 40 on 30-year stroke risk and to examine sex differences.
We included 2608 stroke-free individuals from the Akershus Cardiac Examination 1950 Study, a Norwegian regional study conducted in 2012-2015 of the 1950 birth cohort, who had previously participated in the Age 40 Program, a nationwide health examination study conducted in 1990-1993. We categorised participants by systolic blood pressure (SBP) at age 40 (<120 mm Hg (reference), 120-129 mm Hg, 130-139 mm Hg and ≥140 mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes.
The mean age was 40.1±0.3 years (50.4% women) and mean SBP was 128.3±13.5 mm Hg (mean±SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4±2.9 years of follow-up. SBP between 130 and 139 mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP ≥140 mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95% CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions.
SBP ≥140 mm Hg was significantly associated with 30-year stroke risk in both sexes. A small subgroup of women had SBP ≥140 mm Hg and systolic hypertension was a strong risk factor for stroke in these women.
NCT01555411.
美国和欧洲的指南对高血压的定义不同，且不考虑性别因素。我们的目的是评估 40 岁时不同的高血压阈值对 30 年卒中风险的影响，并探讨性别差异。
我们纳入了来自阿克什胡斯心脏检查 1950 研究的 2608 例无卒中个体，该研究是 2012-2015 年在挪威区域性开展的 1950 年出生队列的一项研究，参与者此前参加过全国性健康检查研究年龄 40 计划，该研究于 1990-1993 年进行。我们根据收缩压（SBP）在 40 岁时的情况（<120mmHg（参考值）、120-129mmHg、130-139mmHg 和≥140mmHg）对参与者进行分类，并使用调整年龄、性别、吸烟、胆固醇、体力活动、肥胖和教育的 Cox 比例风险回归来比较卒中风险。从 2012 年 1 月 1 日至 2020 年 12 月 31 日，我们从挪威心血管疾病登记处获得了卒中数据，此外还从自我报告的卒中中获得了数据。
平均年龄为 40.1±0.3 岁（50.4%为女性），平均 SBP 为 128.3±13.5mmHg（平均值±标准差）。在 29.4±2.9 年的随访期间，115 例（4.4%）个体发生卒中（32 例（28%）为女性，83 例（72%）为男性）。SBP 在 130-139mmHg 之间与卒中无关（调整后的 HR 1.71，95%CI 0.87 至 3.36），而 SBP≥140mmHg 与卒中风险增加相关（调整后的 HR 3.11，95%CI 1.62 至 6.00）。女性的调整后卒中风险 HR 为 4.32（95%CI 1.66 至 11.26），男性为 2.66（95%CI 1.03 至 6.89），性别间无显著交互作用。
SBP≥140mmHg 与两性 30 年卒中风险显著相关。一小部分女性的 SBP≥140mmHg，且收缩压升高是这些女性卒中的强烈危险因素。
NCT01555411。
