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中国社区人群中心血压与外周血压变化与新发高血压之间的关联

Association Between Changes in Central Blood Pressure and Peripheral Blood Pressure With New-Onset Hypertension in a Chinese Community-Based Population.

作者信息

Li Kaiyin, Fan Fangfang, Gao Lan, Jia Jia, Jiang Yimeng, Li Jianping, Zhang Yan, Huo Yong

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, China.

Institute of Cardiovascular Disease, Peking University First Hospital, Beijing, China.

出版信息

J Clin Hypertens (Greenwich). 2024 Dec;26(12):1479-1486. doi: 10.1111/jch.14920. Epub 2024 Oct 24.

Abstract

Spot central and peripheral blood pressure are predictors for future hypertension, but the associations between central or peripheral systolic blood pressure (SBP) changes and new-onset hypertension are unclear. Annual changes in central and peripheral SBP over a mean interval of 2.36 years were calculated for 815 Chinese community residents without cardiovascular disease and hypertension at the first two visits, with the formula: ([2 SBP-1 SBP]/1 SBP) × 100%/time interval (years). The independent and joint associations of these SBP changes with new-onset hypertension at the third visit were assessed with multivariable logistic regression models. During a mean follow-up interval of 4.37 years since the second visit, 171 new cases of hypertension were observed. Central and peripheral SBP changes were significantly associated with new-onset hypertension (central SBP change rate: odds ratio [OR]: 1.19 [95% confidence intervals (CI) 1.13, 1.26]; peripheral SBP change rate: OR: 1.25 [95% CI 1.17, 1.33]), even after adjusting for each other. Compared to the group with neither SBP increased, the group with both SBPs increased showed a significantly higher risk of new-onset hypertension (OR: 4.52 [95% CI 2.54, 8.04]). The model including both SBP changes had a higher area under the curve (AUC) for predicting hypertension in receiver operating characteristic (ROC) analyses than those with either change alone. Central and peripheral SBP changes are independently and jointly associated with new-onset hypertension. It is recommended to regularly monitor both central and peripheral blood pressures.

摘要

诊室中心和外周血压是未来高血压的预测指标,但中心或外周收缩压(SBP)变化与新发高血压之间的关联尚不清楚。对815名首次两次就诊时无心血管疾病和高血压的中国社区居民,计算平均2.36年期间中心和外周SBP的年度变化,公式为:([第2次SBP - 第1次SBP]/第1次SBP)×100%/时间间隔(年)。采用多变量逻辑回归模型评估这些SBP变化与第三次就诊时新发高血压的独立及联合关联。自第二次就诊后的平均4.37年随访期间,观察到171例新发高血压病例。即使相互调整后,中心和外周SBP变化仍与新发高血压显著相关(中心SBP变化率:比值比[OR]:1.19[95%置信区间(CI)1.13,1.26];外周SBP变化率:OR:1.25[95%CI 1.17,1.33])。与SBP均未升高的组相比,SBP均升高的组新发高血压风险显著更高(OR:4.52[95%CI 2.54,8.04])。在接受者操作特征(ROC)分析中,包含两种SBP变化的模型预测高血压的曲线下面积(AUC)高于仅包含一种变化的模型。中心和外周SBP变化与新发高血压独立且联合相关。建议定期监测中心和外周血压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/095b/11654846/2bd831a5d0fb/JCH-26-1479-g002.jpg

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