老年男性原发性高血压患者收缩压水平降低对心脑血管事件的影响

目的探讨老年男性原发性高血压患者降压治疗后,收缩压(SBP)水平与心脑血管事件发生的关系。方法采用回顾性研究方法 ,将836例老年男性原发性高血压患者,按降压治疗后SBP水平分为7组:1组29例,SBP110 mm Hg(1 mm Hg=0.133 kPa);2组71例,SBP 110～11 9 mm Hg;3组224例,SBP 120～1 29 mm Hg,4组290例,SBP 1 30～1 39 mm Hg,5组150例,SBP 140～149 mm Hg,6组45例,SBP 150～1 59 mm Hg,7组27例,SBP≥1 60 mm Hg;应用COX比例风险模型分析不同SBP水平对心脑血管事件的影响。结果与4组比较,6组和7组心脑血管事件发生相对风险分别增加了123%和251%(P0.01);在校正传统危险因素后,与4组比较,1组、6组和7组心脑血管终点事件发生相对风险分别增加了118%、75%和148%(P0.05),心脑血管事件发生与SBP水平呈"J型曲线"现象。结论老年原发性高血压患者SBP水平过高或过低,均显著增加心脑血管事件,SBP在130～139 mm Hg是老年男性高血压患者合适的目标血压范围。

Influence of level of decrease in SBP on cardiovascular and cerebrovascular risks in the elderly men with essential hypertension

Objective To investigate the relationship between the different systolic blood pressure (SBP) levels and cardiovascular and cerebrocascular events in the old male patients with essential hypertension(EH).Methods In this retrospective study,836 elderly men with EH were divided into 7 groups based on the SBP levels after treated with medicines:group 1(SBP<110 mm Hg. 1 mm Hg=0.133 kPa),group 2(SBP 110-119 mm Hg),group 3(SBP 120-129 mm Hg),group 4(SBP 130-139 mm Hg),group 5 (SBP 140-149 mm Hg),group 6(SBP 150-159 mm Hg), group 7(SBP≥160 mm Hg).The COX multivariate proportional hazards regression was used to analyze the influence of the SBP after treatment on cardiovascular and cerebrovascular risks.Results Compared with group 4,the relative risks of cardiovascular and cerebrovascular events in group 6 and group 7 increased by 123% and 251% respectively.The relative risks of cardiovascular and cerebrovascular events in group 1,group 6 and group 7 increased by 118%,75% and 148% respectively compared with group 4 after adjusting the traditional risk factors.There was a J-shaped curve relationship between the SBP levels and the RR of cardiovascular and cerebrovascular events.Conclusion Either significantly high or low SBP level increases the cardiovascular and cerebrovascular risk significantly in the elderly men with EH.130 mm Hg to 139 mm Hg is the suitable target SBP range in the old male EH patients.