脉压及平均动脉压对中老年人脑卒中预测价值的队列研究

目的探讨中老年人脉压及平均动脉压水平对脑卒中发病的预测价值。方法对10 867例中老年人群进行基线调查,其中中年组7 635例,老年组3 232例,随访8年,应用Cox回归分析脉压、平均动脉压对脑卒中的预测价值。结果脉压、平均动脉压均为中老年人脑卒中发病的危险因子。校正其他因素及舒张压后,中年人脉压、平均动脉压每增加10 mm Hg(1 mm Hg=0.133 kPa),脑卒中的发病危险分别增加32.4%和100.8%,且平均动脉压与脑卒中发病危险独立于收缩压;老年人脉压每增加10 mm Hg,脑卒中的危险增加9.1%,但不独立于收缩压。结论平均动脉压对中年人脑卒中的预测作用大于脉压,且独立于收缩压。脉压能在平均动脉压、舒张压水平上提供额外的危险分层信息,但不独立于收缩压。

The cohort study on the predictive value of pulse pressure and mean arterial pressure for stroke in middle-aged and senile population

Objective To explore the predictive value of pulse pressure(PP) and mean arterial pressure(MAP) for the incidence of stroke in middle-aged and senile population.Method The baseline survey of middle-aged and senile population of shandong province was carried out in the year 1991.A total of 509 stroke events occurred among the 10?867 subjects during 8 years of follow-up.The correlation between the two blood pressure indices and stroke was analyzed using Cox regression model.Results Both PP and MAP were predictors of stroke among middle-aged and senile population.In middle-aged population,for each 10 mmHg increase in PP or MAP,there was 32.4% or 100.8% increase in the risk of stroke respectively,and the predictive value of MAP is independent of systolic blood pressure(SBP).On the contrary,in senile population,MAP is a weaker predictive facotor than PP,and for each 10 mm Hg increase in PP,there was an 9.1% increase in the risk of stroke.Conclusion MAP is stronger independent predictive factor for stroke than PP in middle-aged population.However,PP is an independent risk factor for stroke after MAP and diastolic blood pressure were adjusted,but the predictive value is not independent of SBP.