Madore F, Stampfer M J, Rimm E B, Curhan G C
Renal Division, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Am J Hypertens. 1998 Jan;11(1 Pt 1):46-53. doi: 10.1016/s0895-7061(97)00371-3.
A positive association between nephrolithiasis and blood pressure has been suggested in previous studies. However, controversy remains, due to methodological problems in some of the previous studies and absence of prospective data. We evaluated the relationship between nephrolithiasis and the risk of hypertension in a cohort of 51,529 men followed prospectively for 8 years. Information was obtained by biennial mailed questionnaires. At baseline in 1986, 4111 (8.0%) subjects reported a history of nephrolithiasis and 11,623 (22.6%) a diagnosis of hypertension. A positive association was found between the two disorders (age adjusted odds ratio [OR]: 1.31; 95% confidence interval [CI]: 1.30 to 1.32). Among men who reported both disorders, 79.5% reported that the occurrence of nephrolithiasis was prior to or concomitant with the diagnosis of hypertension. Among men without hypertension at baseline, the odds ratio for incident hypertension in men with a history of nephrolithiasis compared with those without was 1.29 (95% CI: 1.12 to 1.41; adjusted for age, body mass index, and intake of calcium, sodium, potassium, magnesium, and alcohol). The occurrence of incident nephrolithiasis during follow-up was similar in men with hypertension at baseline compared with that in men without (adjusted OR: 0.99, 95% CI: 0.82 to 1.21). These data support the hypothesis that prior occurrence of nephrolithiasis increases the risk of subsequent hypertension.
既往研究提示肾结石与血压之间存在正相关。然而,由于既往部分研究存在方法学问题且缺乏前瞻性数据,争议仍然存在。我们在一个对51529名男性进行了8年前瞻性随访的队列中评估了肾结石与高血压风险之间的关系。信息通过每两年邮寄一次问卷获得。在1986年基线时,4111名(8.0%)受试者报告有肾结石病史,11623名(22.6%)被诊断为高血压。发现这两种疾病之间存在正相关(年龄调整优势比[OR]:1.31;95%置信区间[CI]:1.30至1.32)。在报告有这两种疾病的男性中,79.5%报告肾结石的发生先于或与高血压诊断同时出现。在基线时无高血压的男性中,有肾结石病史的男性发生高血压的优势比与无肾结石病史的男性相比为1.29(95%CI:1.12至1.41;根据年龄、体重指数以及钙、钠、钾、镁和酒精摄入量进行调整)。基线时有高血压的男性与无高血压的男性相比,随访期间新发肾结石的发生率相似(调整后OR:0.99,95%CI:0.82至1.21)。这些数据支持了肾结石的先前发生会增加随后发生高血压风险这一假说。