中国三城市脑血管病危险因素干预前后效果评价

目的 评价社区人群脑血管病危险因素干预效果。方法 1997～2000年选取长沙、北京、上海三城市社区居民约30万人,按整群抽样方法随机抽取35～74岁2586人(干预组)和2723人(对照组),统一检查血压、血脂、吸烟、饮酒情况及体重指数(BMI),并将其作为干预效果评价指标。在干预社区人群中进行健康宣教,戒烟、控酒并对糖尿病及高血压病人进行强化治疗。3年后按同样方法分别在干预组和对照组抽取2544人和2523人,对上述指标进行复查。结果 干预组平均收缩压下降3．2mmHg(1mmHg=0．133kPa),平均血清胆固醇下降0．58mmol／L,平均甘油三酯增高0．48mmol／L。干预后两组平均血糖均有增高,但对照组平均血糖净增高0．30mmol／L。两组平均高密度脂蛋白胆固醇均有增高,但差异不明显。对照组平均BMI增高了0．56kg/m^2,干预组未见明显变化;干预组男性人群吸烟率下降了5．4％,女性人群吸烟率下降了2．4％,对照组无变化。结论 通过进行社区干预,脑血管病危险因素水平可明显下降。     

首都钢铁公司5137名男工心肌梗死发病危险因素的研究

目的　通过对 5 137名首都钢铁公司 (首钢 )男性工人平均随访 2 0 84年 ,确认中国人群心肌梗死独立的危险因素 ,了解有关因素对发病的作用强度。方法　研究对象为 1974、1979和1980年先后进行冠心病危险因素调查的首钢 5 137名男性职工 ,平均年龄 (45 2± 7 8)岁 ,对其心肌梗死的发病情况进行了平均 2 0 84年的随访 ,分析基线调查的危险因素 (年龄、血压、血清总胆固醇含量、吸烟 )和心肌梗死发病的关系。结果　 (1)年龄是心肌梗死发病的独立危险因素 ,5 0岁后心肌梗死发病率增加。当控制血压、血清总胆固醇和吸烟状况后 ,年龄每增加 5岁 ,心肌梗死的发病危险增加 2 0 %。 (2 )随血清总胆固醇水平的增加 ,心肌梗死的发病率升高 ,血清总胆固醇≥ 4 6 8mmol/L时 ,发病率增加 ;血清总胆固醇增加 0 5 2mmol/L ,心肌梗死的发病危险增加约 4 0 %。 (3)血压是心肌梗死发病的危险因素。当控制年龄、总胆固醇含量和吸烟后 ,收缩压每增加 2 0mmHg(1mmHg =0 .133kPa)或舒张压每增加 10mmHg ,心肌梗死的发病危险增加约 4 0 %。 (4)吸烟是影响心肌梗死发病最大的危险因素。当应用多元回归分析控制了血压、胆固醇和年龄以后 ,吸烟者比不吸烟者心肌梗死的发病危险增加 137%。 (5 )Cox回归结果显示 ,血压、血     

队列人群脑血管病危险因素干预效果评价

目的：分析队列人群脑血管病危险因素干预前后变化及对脑卒中发病的影响，评价干预效果。方法：1987年在长沙市区选取1个干预社区和1个对照社区，选择具有可比性的两组人群，对35岁以上居民的脑血管病危险因素进行调查，作为基线指标，并将其作为随访对象（已确诊的脑血管病患者除外）。对干预组进行14年的脑血管病危险因素综合干预，同时监测脑卒中发病情况，2000年进行复查。结果：14年后，干预组高血压、糖尿病患病率和平均收缩压、舒张压、体重均增加，其变化分别为33.8％-35.7％，30/万-129/万，128.41-134.49mmHg(1mmHg=0.133kPa)，77.78-78.54mmHg，54.80-57.78kg，对照组上述值的变化分别是从35.9％-56.8％，30/万-228/万，127.70-141.80mmHg，78.27-82.89mmHg，54.92-59.69kg，除干预组的高血压患病人数和舒张压增加未达到统计学意义外，其余各指标增加差异均具有显著性，但均以对照组增加明显；两组人群的饮酒率均有显著性下降，吸烟虽有下降但差异无统计学意义，两组人群进行比较，无论吸烟率还是饮酒率变化差异均无显著性；干预组累积脑卒中发病率（3.4％）明显低于对照组（4.7％）。结论：高血压、糖尿病等脑血管病的危险因素随着年龄的增长也逐渐递增，但进行积极干预可明显控制危险因素的增长，进而降低脑卒中的发病率。     

浙江省社区高血压综合防治研究

目的 通过以社区为基础对一般人群、高危人群和高血压现患人群进行5年的高血压及相关危险因素的综合干预，降低高血压和心血管急性事件的发生率和死亡率。探讨以社区为基础的高血压综合防治模式。方法 选择嘉兴、丽水、绍兴三地区分别代表农村、城镇社区、城市，每个地区均设有干预区和对照区。在干预区内对一般人群进行健康促进，对高危人群进行强化干预，对患病人群进行系统管理。结果 通过社区综合干预，(1)提高了人群高血压知识知晓率、服药率(44．65％)和血压控制率(11．78％)；(2)多种高血压危险因素得到进一步控制；(3)高血压患者收缩压下降2．69mmHg．舒张压下降了3．22mmHg；(4)心血管急性事件的发生率和死亡率逐年降低。结论 以社区为基础的高血压综合干预措施对减少人群的高血压危险因素水平，增加高血压患者的治疗率和血压控制率，降低心血管急性事件的发生率和死亡率不仅有效，而且是切实可行的。     

脑血管病危险因素干预实验——37661队列人群的血压变化

本研究报告分析了在中国七个大城市进行的脑血管病危险因素干预实验对队列人群血压的影响.37661名35岁以上市区居民分为干预组和对照组.研究结果显示;干预组收缩压和舒张压均值复查比基线时有所下降.而对照组正好相反,都有所上升.干预组确诊高血压的比例从基线时的18.4%降至复查时的15.5%,而对照组则从17 5%上升至17.7%.在基线血压正常且以往无高血压史者中,干预组男性与女性确诊高血压的发病率分别为6.5%和4.9%,都低于对照组的7.6%和8.0%.脑卒中的发病率随血压(收缩压或舒张压)的增高而上升,几乎在各个血压等级中,干预组脑卒中发病率都低于对照组.上述干预组和对照组之间的差别都具有统计学显著意义.     

北京房山社区人群心血管病1991 ～ 1999 年 综合防治效果评价

目的探索在我国农村社区人群中防治心血管病的可持续的有效途径和措施.方法采取全人群与高危人群相结合的防治策略,以健康教育和积极控制高血压为主要手段.干预措施包括(1)建立健全县、乡、村三级防治网;(2)定期对基层医务人员进行心血管病防治培训;(3)开展经常性的健康教育和健康促进活动;(4)对年龄≥30岁的人群进行高血压筛查、管理和防治指导.结果基线调查和2次复查分别于1991年和1995、1999年完成.经过9年干预,干预区人群心血管健康知识、态度和行为,高血压的知晓率、治疗率和控制率,一些营养素的摄入以及多数心血管病的危险因素均发生预期的良性改变;干预区人群脑卒中的平均发病率和平均死亡率分别比对照区低18.7%(u=2.81,P＜0.01)和17.7%(u=2.91,P＜0.01);干预区冠心病的平均发病率和平均死亡率分别比对照区低4.9%和4.3%,但差异未达到统计学显著性水平.干预区和对照区人群的体重指数和血脂水平均有所升高.结论房山农村社区心血管病综合防治途径和措施切合农村实际,取得明显成效.     

对高血压高危人群进行生活方式干预效果评价

目的评价对高血压高危人群实施生活方式干预的效果。方法从2005年10月至2007年10月进行体检的人员中抽取104名血压处于高血压病前期（血压为120～139／80～90mmHg）,存在2种以上高血压危险因素的体检者。将其随机分为干预组（50例）与对照组（54例）,对干预组进行为期2年的生活方式干预,包括健康教育（含疾病认知）、饮食、运动、心理等方面的干预指导;并对实施前后疾病认知、血压、体重及危险因素增减进行对比。结果通过2年生活方式干预,干预组疾病认知率明显提高,血压、体重下降明显,疾病危险因素明显减少;而对照组虽然疾病认知率有所提高,疾病危险因素也有所下降,但血压、体重有不同程度上升。2年后,干预组与对照组平均收缩压之差为13．0mmHg（1mmHg=0．133kPa）、舒张压之差为7．9mmHg、体重之差为3．7kg,疾病认知率之差为37．6％,两组对比差异均有统计学意义（均P〈0．05）。结论对高血压高危人群实施生活方式干预,能有效降低血压和体重,并能随新的生活方式的逐步形成而减少导致疾病发生的危险因素。     

北京25～64岁人群1984～1999年体重指数和超重率变化趋势的研究

目的：分析1984－1999年北京地区25－64岁人群平均体重指数（BMI）、超重率的变化趋势。方法：在北京地区心血管病监测人群中，分别进行了5次心血管病危险因素的横断面调查。结果：1984－1999年25－64岁人群平均BMI由23．3增加到24．0，超重率由27．5％增加到35．9％。男性人群超重率由23．5％增加到43．4％。男性各年龄组及城乡地区的超重率均呈增加趋势。女性人群在城乡地区的超重率呈不同变化趋势，城市女性超重率由36．0％下降到23．3％，农村女性超重率由28．4％增加到46．0％。城市人群的超重率由29．1％增加到31．8％，农村人群的超重率由22．1％增加到49．6％。研究早期城市人群的平均BMI和超重率大于农村人群（P＜0．05），到研究后期农村人群的BMI和超重率赶上并超过城市人群（P＜0．05）。结论：城市男性和农村男女两性人群BMI和超重率均呈上升趋势，但农村人群的上升速度较快，且平均BMI和超重率目前已高于城市人群。     

北京部分地区15年脑卒中事件变化趋势—WHO—SINO—MONICA研究

目的 探讨脑卒中在北京地区变化趋势。方法 采用北京地区心血管病人群监测（WHO MONICA方案）诊断标准，通过三级监测网对人群脑卒中发病进行登记监测。结果 ①北京人群15年间（1984－1988年）脑卒中标化发病率呈显著上升的趋势（＋9．0％／年，P＝0．039）。男性为（＋11．4％／年，P＝0．027），女性为（＋8．2％／年），但无显著性差异；人群脑卒中首次发作标化发病率也呈上升的趋势（＋9．1％／年，P＝0．023），男性较女性上升更明显。②人群脑卒中标化死亡呈显著下降的趋势（－6．6％／年，P＝0．042）。城市人群较农村人群下降明显。③人群脑卒中病死率下降趋势明显（－16．7％／年，P＝0．014）。女性较男性更明显。结论 人群脑卒中发病率15年来呈显著上升的趋势，主要是首次发生率的增加，并且与高血压患病率相平等，人群高血压的防治势在必行。     

北京部队驻京干休所老干部脑卒中患病情况调查分析

目的 对驻京部队部分离退休老干部脑卒中的患病情况进行流行病学调查，分析脑卒中患者合并心血管病主要危险因素的状况。方法 在我区驻京干休所离退休老干部中进行心血管病危险因素流行病学调查，分析89例脑卒中患者并存高血压、糖尿病和血脂的控制情况。结果 本人群基线调查时脑卒中总患病率为19．59％，其中缺血性脑卒中患病率为17．95％，出血性脑卒中为1．64％，缺血性脑卒中患病率显著高于出血性脑卒中（P〈0．01）。与2002年调查时比较，2003—2006年脑卒中发病率、复发率显著减少，总发病率分别下降了58．84％、64．63％、47．56％和51．22％，差异均有统计学意义（P〈0．01），其中主要是缺血性脑卒中发病率显著减少。脑卒中患者合并高血压、糖尿病、血脂控制异常的比率与本人群该疾病的患病率差异无统计学意义。结论 本人群基线调查时脑卒中的患病率高于我国老年人群的患病率，经过综合干预后脑卒中的发病率与复发率显著下降。     

安徽省心血管病患病风险人群社区公共卫生综合干预对血压水平控制效果分析

  目的  分析不同心血管疾病(cardiovascular disease, CVD)患病风险人群社区公共卫生综合干预血压控制效果。  方法  收集2016—2020年安徽省社区公共卫生综合干预资料(包括基线、3个月、12个月随访数据),采用《中国心血管疾病风险评估和管理指南》推荐的10年CVD风险评估模型将研究对象分为心血管疾病高危和非高危人群,比较高危和非高危人群社区公共卫生综合干预血压控制效果。  结果  共随访3 755名研究对象,CVD高危人群645人,标化检出率10.9%。随访12个月与基线相比,高危人群SBP和DBP分别下降了16.47 mm Hg(95% CI:-18.09~-14.86)、2.66 mm Hg(95% CI:-3.63~-1.69),非高危人群SBP和DBP分别下降了10.43 mm Hg(95% CI:-11.16~-9.70)、2.41 mm Hg(95% CI:-2.81~-2.01);3个月与基线相比,高危人群SBP和DBP分别下降了12.27 mm Hg(95% CI:-13.88~-10.65)、3.66 mm Hg(95% CI:-4.54~-2.77),非高危人群SBP和DBP分别下降了6.05 mm Hg(95% CI:-6.80~-5.30)、2.61 mm Hg(95% CI:-3.00~-2.23)。高危人群随访3个月后SBP下降水平、随访12个月后SBP和DBP下降水平明显高于非高危组(t=-5.100,t=-5.873,t=-2.729,均有P＜0.05)。  结论  社区公共卫生综合干预对CVD高危人群血压改善优于非高危人群。因此,未来的公共卫生工作应进一步关注非高危人群。     

Shifting the distribution of risk: results of a community intervention in a Swedish programme for the prevention of cardiovascular disease

STUDY OBJECTIVE: To examine the impact of a systematic risk factor screening and counselling carried out by family physicians and family nurses within the larger framework of a community intervention programme for the prevention of cardiovascular disease (CVD). DESIGN: Quasi-experimental study comparing trends in an intervention area with those in a reference area. SETTING: A Northern Sweden municipality (5500 inhabitants) constituted the intervention area while the Northern Sweden region (510,000 inhabitants) served as the reference area. PARTICIPANTS: All 30, 40, 50, and 60 year old inhabitants were invited each year from 1985 to 1992. Among 2046 eligible 1893 participated (92.5%), which formed eight independent cross sections. One cross section, 1986, was re-surveyed forming a panel. MAIN RESULTS: In the cross sections, mean total cholesterol was reduced from 7.09 to 6.27 mmol/l for men (p < 0.001) and from 7.13 to 5.89 mmol/l for women (p < 0.001) and mean systolic blood pressure from 132.2 to 123.7 mm Hg for men (p < 0.05) and from 129.2 to 122.0 mm Hg for women (p < 0.001) during the eight years. Body mass index (BMI) increased from 25.6 to 26.2 for men (p < 0.05) and from 25.0 to 25.5 for women (NS). A corresponding reduction in cholesterol and blood pressure (for women) occurred in the panel, while BMI was unchanged. The risk for CVD, using the Framingham equation, was estimated to be reduced overall by 19% (p = 0.0021) when comparing early cross sections (1985/86) with the later cross sections (1990/91). CONCLUSIONS: It was concluded that a long term community based CVD prevention programme that combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. The individual attention and evaluation provided by the health provider survey seem to accelerate, but not increase the amount of, risk reduction.     

Effects of Val-Pro-Pro and Ile-Pro-Pro on nondipper patients: a preliminary study

Much clinical evidence on the antihypertensive effects of the milk-derived antihypertensive peptides Val-Pro-Pro and Ile-Pro-Pro (lactotripeptides) has been reported. However, circadian rhythm effects determined by ambulatory blood pressure monitoring (ABPM) to eliminate the confounding influence of the white-coat effect have not been fully studied. Twelve hypertensive patients not receiving antihypertensive medication (2 men, 10 women; mean age±standard deviation, 63.5±8.3 years) who had been visiting our clinic for more than 1 year participated in this study. Mean (±standard deviation) systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 142.4±2.6 and 83.5±6.4?mm Hg, respectively, at the first office visit. After patients ingested a fermented milk product containing antihypertensive peptides (2.53?mg Val-Pro-Pro; 1.52?mg Ile-Pro-Pro) for more than 4 weeks, both office SBP and DBP were significantly reduced to a mean (±standard deviation) of 133.3±7.0?mm Hg and 76.5±8.4?mm Hg (P<.001 and P<.005 by paired t-test), respectively. The 24-hour SBP and DBP determined by ABPM were reduced from 127.3±2.4 and 78.7±2.3?mm Hg to 120.2±2.4 and 75.0±2.2?mm Hg (P<.001 and P<.05), respectively. Awake-time SBP (08:00-21:00), night-time SBP (0:00-05:00), and early-morning SBP (06:00-07:00) were reduced from 130.9±2.4 to 123.3±2.3?mm Hg, 118.7±2.9 to 113.2±3.4?mm Hg, and 132.8±4.3 to 122.4±3.9?mm Hg (by paired t-test: P<.001, P<.05, and P<.05), respectively. As seen with DBP measured by ABPM, 24-hour DBP and awake-time DBP were significantly reduced from 78.7±2.3 to 75.0±2.2?mm Hg and 82.1±2.5 to 77.3±2.2?mm Hg (P<.05 and P<.01), respectively. Office BP and 24-hour blood pressure did not significantly differ between the dipper and nondipper groups at baseline. However, after treatment, night-time and early-morning blood pressure were significantly reduced from baseline in the nondipper group (-8.5±2.5 and -15.6±3.7?mm Hg; P<.05 and P<.01, respectively) but not in the dipper group (-2.5±3.6 and -1.2±4.7?mm Hg; P not significant), and the reduction in early-morning blood pressure significantly differed between the groups (P<.05). These results suggest that Val-Pro-Pro and Ile-Pro-Pro decrease blood pressure in patients with stage I hypertension and result not only in lower blood pressure at night-time but also in lower early-morning SBP in nondipper patients.     

基于学校的小学生家庭减盐健康教育前后血压变化分析

目的 了解长治市市区小学生及其家长有关高血压及其影响因素的相关知识，探讨家庭减盐健康教育在控制血压中的作用，为高血压的有效防控提供参考依据。方法 从长治市28所小学的五年级中各选取一个班，随机分为干预组和对照组，每班中再随机抽取10名学生及其家长作为研究对象。干预组学生进行3.5个月的减盐健康教育，并将减盐相关知识传递给家长。然后对两组学生和家长进行健康教育前后的问卷调查和体格检查。结果 学生和家长健康教育后对食盐推荐摄入量的知晓率提高。健康教育后干预组家长收缩压（systolic blood pressure，SBP）较之前增加了（1.79±11.35） mm Hg，对照组增加了（4.73±13.24） mm Hg，差别有统计学意义（t=2.703，P=0.007）；健康教育后干预组家长舒张压（diastolic blood pressure，DBP）增加（1.37±9.50） mm Hg，对照组增加（3.09±10.23） mm Hg，差别有统计学意义（t=2.711，P=0.007）。多元回归分析结果显示干预组女性体质指数（body mass index，BMI）越高，基线SBP越低，则家长的SBP差值越大；干预组BMI越高，基线DBP越低，则家长的DBP差值越大。结论 小学生家庭减盐健康教育可以有效地降低家长的血压水平，对高血压的防控有一定的参考意义。     

Randomized Trial on the Effects of Dietary Potassium on Blood Pressure and Serum Potassium Levels in Adults with Chronic Kidney Disease

In the general population, an increased potassium (K) intake lowers blood pressure (BP). The effects of K have not been well-studied in individuals with chronic kidney disease (CKD). This randomized feeding trial with a 2-period crossover design compared the effects of diets containing 100 and 40 mmol K/day on BP in 29 adults with stage 3 CKD and treated or untreated systolic BP (SBP) 120–159 mmHg and diastolic BP (DBP) <100 mmHg. The primary outcome was 24 h ambulatory systolic BP. The higher-versus lower-K diet had no significant effect on 24 h SBP (−2.12 mm Hg; p = 0.16) and DBP (−0.70 mm Hg; p = 0.44). Corresponding differences in clinic BP were −4.21 mm Hg for SBP (p = 0.054) and −0.08 mm Hg for DBP (p = 0.94). On the higher-K diet, mean serum K increased by 0.21 mmol/L (p = 0.003) compared to the lower-K diet; two participants had confirmed hyperkalemia (serum K ≥ 5.5 mmol/L). In conclusion, a higher dietary intake of K did not lower 24 h SBP, while clinic SBP reduction was of borderline statistical significance. Additional trials are warranted to understand the health effects of increased K intake in individuals with CKD.     

Body composition, ethnicity and alcohol consumption as determinants for the development of blood pressure in a birth cohort of young middle-aged men

Aim: To investigate the development of blood pressure (BP) determinants over a period of 6 years in a birth cohort of middle-aged Swedish men. Methods: Men born 1953 and 1954 living in Helsingborg, Southern Sweden, were surveyed at 37, 40 and 43 years of age. Baseline participation rate was 68% (n = 991). S-Cholesterol, HDL-Cholesterol, systolic and diastolic blood pressure (SBP and DBP) and anthropomorphic measurements were collected and a questionnaire covering ethnicity, smoking, leisure time physical activity (LTPA) and alcohol consumption was completed. Results: At these surveys, SBP means were: 131, 132, 135 mm Hg and DBP were 83, 83 and 85 mm Hg respectively. Body mass index (BMI), waist hip ratio (WHR), S-Cholesterol and alcohol consumption consistently showed cross-sectional positive associations with SBP and DBP. One mmol/L higher S-Cholesterol at baseline predicted an increase in SBP by 1.16 mm Hg (confidence interval, CI: 0.25; 2.07) over 6 years. At age 40, there was a 4.4 mm Hg (p < 0.020) difference in SBP and a 2.64 mm Hg (p < 0.056) difference in DBP means between the low and high alcohol consumption. Corresponding differences at age 43 were SBP 5.28 mm Hg (p < 0.023) and DBP 5.4 mm Hg (p < 0.000). Men born in Sweden had a higher baseline SBP ( = 4 mm Hg, CI: 2.11; 6.35) and showed a higher 6 year increase in SBP (2.80 mm Hg CI: 0.07; 5.53) than men born abroad. Conclusions: Body composition, ethnicity and alcohol consumption are strong determinants for the development of BP. These findings have to be considered in strategies for primary prevention of hypertension in younger middle-aged men.     

Assessing Cardiovascular Reactivity in Working Women with the Social Competence Interview

ABSTRACT

The Social Competence Interview (SCI), an interview to induce cardiovascular reactivity through recounting a stressful life experience, was used with a sample of 120 working women employed as childcare providers. Women recounted their most stressful work factor while cardiovascular reactions were monitored at 2-minute intervals (data points included 4 baseline, 6 SCI, and 3 recovery). Increases were found when comparing mean baseline and SCI measures: systolic blood pressure (SBP) increased 10.00 mm Hg; diastolic blood pressure (DBP) increased 10.63 mm Hg; and heart rate increased 4.57 beats per minute. Consistent with the literature SBP and DBP were higher for some subgroups of women (those who were 50 years or older, were obese, or had 4 or more risk factors) across all data points. There were no time by individual difference interactions, indicating that the patterns of change over time were the same across groups. In a logistic regression, comparing women who reached SBP ≥ 140 mm Hg and/or DBP ≥ 90 mm Hg during the SCI versus those who did not, higher BP was associated with being older and obese, having a higher level of acceptance coping, and a lower level of suppression of competing activities coping.     

Coffee intake and incidence of hypertension

BACKGROUND: The long-term longitudinal evidence for a relation between coffee intake and hypertension is relatively scarce. OBJECTIVE: The objective was to assess whether coffee intake is associated with the incidence of hypertension. DESIGN: This study was conducted on a cohort of 2985 men and 3383 women who had a baseline visit and follow-up visits after 6 and 11 y. Baseline coffee intake was ascertained with questionnaires and categorized into 0, >0-3, >3-6, and >6 cups/d. Hypertension was defined as a mean systolic blood pressure (SBP) >or=140 mm Hg over both follow-up measurements, a mean diastolic blood pressure (DBP) >or=90 mm Hg over both follow-up measurements, or the use of antihypertensive medication at any follow-up measurement. RESULTS: Coffee abstainers at baseline had a lower risk of hypertension than did those with a coffee intake of >0-3 cups/d [odds ratio (OR): 0.54; 95% CI: 0.31, 0.92]. Women who drank >6 cups/d had a lower risk than did women who drank >0-3 cups/d (OR: 0.67; 95% CI: 0.46, 0.98). Subjects aged >or=39 y at baseline had 0.35 mm Hg (95% CI: -0.59, -0.11 mm Hg) lower SBP per cup intake/d and 0.11 mm Hg lower DBP (95% CI: -0.26, 0.03 mm Hg) than did those aged <39 y at baseline, although the difference in DBP was not statistically significant. CONCLUSIONS: Coffee abstinence is associated with a lower hypertension risk than is low coffee consumption. An inverse U-shaped relation between coffee intake and risk of hypertension was observed in the women.     

低钠富钾替代盐对农村社区人群血压影响的现场观察

目的 评价市售低钠富钾替代盐对农村社区居民血压的影响效果。方法采用流行病学类实验设计,在山东省莱芜市2个农村社区,经过血压筛查,将411名30～ 60岁的研究对象分为高血压组和非高血压组,两组均以家庭为单位给予3个月的低钠富钾替代盐替换普通食盐进行干预,定期观察血压及其24 h尿钠的变化。结果用低钠富钾替代盐干预1个月时高血压组和非高血压组人群血压开始呈下降趋势,3个月后评估时高血压组收缩压(SBP)平均下降7.4 mm Hg(1 mm Hg=0.133 kPa;t= 10.096,P=0.000),舒张压(DBP)下降3.8 mm Hg(t=8.017,P=0.000);非高血压组SBP平均下降1.2 mm Hg(t=2.507,P= 0.007),DBP下降1.0 mm Hg(t=2.987,P=0.002)。干预3个月后评估时高血压组24 h尿钠平均下降15.5 mmol(t= 1.803,P=0.037),尿钾上升4.2 mmol(t’=2.132,P=0.018),钠钾比下降1.2(t=2.786,P=0.003);非高血压组24 h尿钠平均下降1.7 mmol(t =0.211,P=0.417),尿钾上升3.7 mmol(t’=2.207,P=0.015),钠钾比值下降0.7(t= 1.818,P=0.036)。结论低钠富钾替代盐能有效降低人群血压水平,且人群依从性较好,是一种有效的非药物预防控制高血压方法。     

Pet ownership and blood pressure in old age

BACKGROUND: It has been proposed that pet ownership improves cardiovascular health. This study examines the relation of pet ownership with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and hypertension in a large sample of older men and women. METHODS: Participants were 1179 community-dwelling men (n = 498) and women (n = 681) age 50-95 years. Participants responded to a 1991-1992 mailed questionnaire ascertaining pet ownership, and they attended a 1992-1996 clinic visit at which systolic (SBP) and diastolic (DBP) blood pressures were measured and use of antihypertensive medication was validated. Pulse pressure was calculated as SBP minus DBP. Mean arterial pressure was calculated as (SBP+DBP)/2. Body mass index, waist-hip ratio, and information on other potential confounders were obtained. RESULTS: Average age of participants was 70.4 +/- 10.8 years; 30.0% reported current pet ownership. Mean SBP was 137.5 +/- 21.4 mm Hg, and DBP was 76.1 +/- 9.3 mm Hg; 55.6% were hypertensive (SBP >or= 140, DBP >or= 90 or taking hypertension medication). Pet owners were younger and slightly more overweight and they exercised less than nonowners; owners were somewhat more likely to have diabetes and to use beta-blockers. In unadjusted analyses, pet owners had lower SBP, pulse pressure, and mean arterial pressure, and a reduced risk of hypertension (odds ratio = 0.62; 95% confidence interval = 0.49-0.80). However, after adjustment for age and other confounders, pet ownership was not associated with systolic or diastolic blood pressure, pulse pressure, mean arterial pressure or risk of hypertension. CONCLUSIONS: Results suggest that pet ownership is not independently associated with blood pressure, vascular reactivity, or hypertension.