Lidfeldt J, Lanke J, Sundquist J, Lindholm L H
Department of Community Health Sciences Dalby/Lund, Lund University, Lund, Sweden.
J Intern Med. 1998 Dec;244(6):469-78.
To evaluate the impact of hypertension and other risk factors on mortality, in particular cardiovascular mortality, in a geographically defined population of elderly subjects.
An observational 25-year study of a total population.
The local health centre in the village of Dalby in southern Sweden.
All men and women born in 1902 or 1903, living in Dalby, were, at the age of 67, invited for medical and psychological examinations. The population comprised 188 subjects (109 men and 79 women); 156 (83%) of them took part in the first medical examination. Blood pressure, heart rate, weight and height were measured and laboratory tests performed at entry. Blood pressures were thereafter recorded six times, and this report is based on a 25-year follow-up period ending in October 1994.
Survival analyses were performed, based on definition of underlying causes of death, divided into all-cause and cardiovascular.
At entry, females had higher blood pressure than males, both at baseline and during the first 16 years of the study, regardless of whether they were hypertensives or not. Most men smoked but only a few women. At the end of the follow-up of the present study in 1994, 138 out of 156 (88%) subjects had died and only 18 (12%) remained alive; 78 (57%) had died of a cardiovascular disease. In men, a diagnosis of hypertension as well as increased blood pressure at entry was associated with increased mortality. In women this was the case for blood pressure and risk of cardiovascular mortality. In men, both systolic and diastolic blood pressures during the study were significant risk factors for death, whereas in women this was not the case.
Elderly male hypertensives ran an increased mortality risk even though they were treated according to the then current guidelines; female hypertensives seemed to run the same risk of dying as normotensive females.
评估高血压及其他危险因素对特定地理区域老年人群死亡率，尤其是心血管疾病死亡率的影响。
一项对总人口进行的为期25年的观察性研究。
瑞典南部达尔比村的当地健康中心。
所有于1902年或1903年出生、居住在达尔比的男性和女性，在67岁时被邀请参加医学和心理检查。该人群包括188名受试者（109名男性和79名女性）；其中156名（83%）参加了首次医学检查。在入组时测量了血压、心率、体重和身高，并进行了实验室检查。此后血压记录了6次，本报告基于截至1994年10月的25年随访期。
基于死亡根本原因的定义进行生存分析，分为全因死亡和心血管疾病死亡。
入组时，无论是否患有高血压，女性在基线时以及研究的前16年中血压均高于男性。大多数男性吸烟，但只有少数女性吸烟。在1994年本研究随访结束时，156名受试者中有138名（88%）死亡，仅18名（12%）存活；78名（57%）死于心血管疾病。在男性中，入组时高血压诊断以及血压升高与死亡率增加相关。在女性中，血压和心血管疾病死亡风险存在这种情况。在男性中，研究期间收缩压和舒张压均为死亡的显著危险因素，而在女性中并非如此。
老年男性高血压患者即使按照当时的现行指南进行治疗，死亡风险仍会增加；女性高血压患者似乎与血压正常的女性有相同的死亡风险。
