Håheim L L, Holme I, Hjermann I, Leren P
Life Insurance Companies Institute of Medical Statistics, Ullevål Hospital, Oslo, Norway.
J Hypertens. 1995 Aug;13(8):909-13. doi: 10.1097/00004872-199508000-00012.
To determine how blood pressure level predicts the incidence of fatal stroke.
The Oslo Study is a prospective cohort study of preventive and epidemiological aspects of cardiovascular disorders in middle-aged men. Of 25,915 men invited, 16,209 aged 40-49 years attended the screening. A 7% random sample of men aged 20-39 years were also invited to attend.
The screening started in May 1972 and the analysis presented is an 18-year follow-up for fatal strokes. Men with a history of stroke were excluded from the analyses.
Of 16,173 men with no history of stroke 85 died from stroke. Results from Cox proportional hazards regression analysis confirm diastolic (DBP) and systolic blood pressure (SBP) as strong independent risk factors of fatal stroke, with DBP being the stronger predictor. Analyses of risk of fatal stroke by quintile values show SBP to give significantly increased risk from the third quintile (136 mmHg), and DBP from the fifth quintile (95 mmHg) relative to the first quintile. No levelling off at highest levels can be seen when analysing decile values. No J-shape of the curve was evident. Men on drug treatment for hypertension with no stroke history (n = 440) had 4.7-fold (crude) and 2.8-fold (adjusted for age and DBP) the rate of stroke mortality of men not on drug treatment for hypertension.
DBP was a stronger predictor than SBP, with increasing risk from the fifth quintile of DBP and the third quintile of SBP. Men on drug treatment for hypertension at screening were at increased risk during the follow-up period, indicating that their treatment did not sufficiently reduce their risk of stroke.
确定血压水平如何预测致命性中风的发生率。
奥斯陆研究是一项针对中年男性心血管疾病预防和流行病学方面的前瞻性队列研究。在受邀的25915名男性中，16209名年龄在40 - 49岁的男性参加了筛查。还邀请了20 - 39岁男性的7%作为随机样本参加。
筛查于1972年5月开始，所呈现的分析是对致命性中风的18年随访。有中风病史的男性被排除在分析之外。
在16173名无中风病史的男性中，85人死于中风。Cox比例风险回归分析结果证实舒张压（DBP）和收缩压（SBP）是致命性中风的强有力独立危险因素，其中DBP是更强的预测因素。按五分位数分析致命性中风风险显示，相对于第一五分位数，SBP从第三五分位数（136 mmHg）起风险显著增加，DBP从第五五分位数（95 mmHg）起风险显著增加。分析十分位数时，在最高水平未见平稳状态。曲线未呈现J形。无中风病史的接受高血压药物治疗的男性（n = 440）的中风死亡率是未接受高血压药物治疗男性的4.7倍（粗算）和2.8倍（经年龄和DBP校正）。
DBP比SBP是更强的预测因素，DBP第五五分位数和SBP第三五分位数起风险增加。筛查时接受高血压药物治疗的男性在随访期间风险增加，表明他们的治疗未能充分降低中风风险。
