Hofman A, Feinleib M, Garrison R J, van Laar A
Br Med J (Clin Res Ed). 1983 Jul 23;287(6387):267-9. doi: 10.1136/bmj.287.6387.267.
Whether a change in blood pressure is related to the occurrence of cardiovascular disease, independent of blood pressure level, was investigated using data collected in the Framingham heart study on 5209 subjects. The follow up period of 26 years was divided into a first period of 12 years in which the blood pressure change was computed for each individual and a subsequent period of 14 years in which the risk of cardiovascular disease was determined. Blood pressure change was positively related to risk of cardiovascular disease. This association remained when blood pressure level at the start of the study was taken into account but disappeared when the level attained after the first 12 years was taken into consideration. For the clinician this suggests that the decision to treat high blood pressure is best guided by the actual level of pressure and not by its long term trend in the past.
利用弗雷明汉心脏研究收集的5209名受试者的数据，研究了血压变化是否与心血管疾病的发生相关，而与血压水平无关。26年的随访期分为两个阶段，第一个阶段为12年，计算每个人的血压变化，第二个阶段为14年，确定心血管疾病的风险。血压变化与心血管疾病风险呈正相关。当考虑研究开始时的血压水平时，这种关联仍然存在，但当考虑前12年达到的水平时，这种关联就消失了。对于临床医生来说，这表明治疗高血压的决定最好由实际血压水平指导，而不是由过去的长期趋势指导。
