Hardy R J, Hawkins C M
Am J Epidemiol. 1983 May;117(5):566-74. doi: 10.1093/oxfordjournals.aje.a113579.
Two important questions regarding the results of the Hypertension Detection and Follow-up Program are: 1) how much of the difference in mortality between stepped care and referred care can be attributed to treatment for hypertension, and 2) was there a relationship between treatment of hypertension in the program and the risk of subsequent mortality of the participants? Neither of these questions can be answered within the original randomization scheme of the Hypertension Detection and Follow-up Program; however, statistical techniques can address these two questions. Crude analyses of blood pressures of survivors and deaths in each year of follow-up indicate that survivors had lower blood pressure than persons dying during the interval. An analysis using life table regression with time-dependent covariates suggests that well over half of the excess risk in the referred care group can be attributed to differences in factors related to hypertension treatment. Simultaneously testing the coefficients of the time-dependent variables (diastolic and systolic pressures, blood pressure goal, and medication status) suggests a highly significant relationship between these variables and the risk of subsequent mortality.
关于高血压检测与随访项目的结果,有两个重要问题:1)阶梯治疗和转诊治疗之间的死亡率差异有多少可归因于高血压治疗?2)该项目中的高血压治疗与参与者随后的死亡风险之间是否存在关联?在高血压检测与随访项目最初的随机分组方案内,这两个问题均无法得到解答;不过,统计技术能够处理这两个问题。对随访各年中幸存者和死亡者的血压进行的粗略分析表明,幸存者的血压低于在此期间死亡的人。一项使用带有随时间变化协变量的生命表回归分析表明,转诊治疗组中超过一半的额外风险可归因于与高血压治疗相关因素的差异。同时检验随时间变化变量(舒张压和收缩压、血压目标和用药状况)的系数表明,这些变量与随后的死亡风险之间存在高度显著的关系。