2017 年 ACC/AHA 指南定义的血压与中国中老年人心血管疾病风险的关联：一项队列研究。

The Association of Blood Pressure Defined by the 2017 ACC/AHA Guidelines and Cardiovascular Disease Risk for Middle-Aged and Elderly People in China: A Cohort Study.

机构信息

Xicheng District Guangwai Hospital - Cardiovascular Medicine, Beijing - China.

Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences - Oncology, Shanghai - China.

出版信息

Arq Bras Cardiol. 2024 Jul;121(7):e20230785. doi: 10.36660/abc.20230785.

DOI:10.36660/abc.20230785

PMID:39194062

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11341210/

Abstract

BACKGROUND

Cardiovascular disease (CVD) is a series of diseases affecting the heart or blood vessels.

OBJECTIVES

To assess the relationship between blood pressure (BP) levels defined by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline and CVD/atherosclerotic cardiovascular disease (ASCVD) risk for middle-aged and elderly people in China.

METHODS

A total of 6,644 middle-aged and elderly people from the China Health and Retirement Longitudinal Study (CHARLS) were finally included. According to the 2017 ACC/AHA guideline, all subjects were divided into four groups: normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension. The outcome of this study was considered as the risk of CVD and ASCVD. Univariate and multivariate COX regression models were adopted to examine the relationship of the 2017 ACC/AHA BP classification with the risk of CVD. Univariate and multivariate logistic regression models were used to investigate the association between BP levels and ASCVD risk. Subgroup analyses based on age, gender, and use of antihypertensive drugs were performed. P<0.05 was accepted as statistically significant.

RESULTS

After adjusting all covariates, compared to middle-aged and elderly patients with normal BP, we found that patients with stage 1/2 hypertension were associated with a higher risk of CVD, separately. Simultaneously, we also observed a positive association between individuals with elevated BP, stage 1 hypertension, stage 2 hypertension, and higher ASCVD risk in the fully adjusted model. The result of subgroup analyses implied that the relationship between stage 1/2 hypertension and CVD/ high ASCVD was robust in different ages and genders, and participants without using antihypertensive drugs.

CONCLUSION

BP classification under the 2017 ACC/AHA BP guidelines may apply to the Chinese population.

摘要

背景

心血管疾病（CVD）是一系列影响心脏或血管的疾病。

目的

评估 2017 年美国心脏病学会/美国心脏协会（ACC/AHA）指南定义的血压（BP）水平与中国中老年人 CVD/动脉粥样硬化性心血管疾病（ASCVD）风险之间的关系。

方法

共纳入中国健康与退休纵向研究（CHARLS）的 6644 名中老年人。根据 2017 年 ACC/AHA 指南，所有受试者分为四组：正常血压、血压升高、1 期高血压和 2 期高血压。本研究的结果被认为是 CVD 风险。采用单变量和多变量 COX 回归模型来检查 2017 年 ACC/AHA BP 分类与 CVD 风险之间的关系。采用单变量和多变量逻辑回归模型来探讨 BP 水平与 ASCVD 风险之间的关系。进行了基于年龄、性别和使用降压药物的亚组分析。P<0.05 被认为具有统计学意义。

结果

调整所有协变量后，与正常血压的中老年人相比，我们发现 1/2 期高血压患者的 CVD 风险更高。同时，我们还观察到在完全调整模型中，BP 升高、1 期高血压、2 期高血压与 ASCVD 风险升高之间存在正相关。亚组分析的结果表明，1/2 期高血压与 CVD/高 ASCVD 之间的关系在不同年龄和性别以及未使用降压药物的人群中是稳健的。