正常高值血压人群10年心血管病发病危险的分析

目的探讨中国35~64岁人群正常高值血压(采用2005年中国高血压指南新的定义)的分布特点、与其他心血管病危险因素的关系及10年心血管病发病危险。方法采用前瞻性队列研究,对1992年建立的11省市35~64岁队列研究共30 378人基线时血压水平、心血管病危险因素分布及10年发生心脑血管病事件(包括冠心病和脑卒中)危险关系进行分析。结果(1)中国35~64岁人群中正常高值血压的现患率为32.2%,其中男性为34.2%,女性为30.2%。(2)正常高值血压人群,收缩压和舒张压均在正常高值范围者最多(45.0%),其次为仅收缩压在正常高值范围者(34.9%),舒张压在正常高值者最少(20.1%)。(3)正常高值血压人群的心血管病危险因素平均水平高于正常血压人群。(4)调整年龄、性别和其他心血管病危险因素后,与正常血压者相比,基线血压在正常高值范围者10年冠心病事件的发病风险增加31%,脑卒中事件的发病风险增加49%,总心血管病事件的发病风险增加44%。结论正常高值血压者心血管病发病危险高于正常血压者,应加强正常高值血压人群高血压及心脑血管事件的早期防治。

The 10-year cardiovascular risk in a Chinese cohort aged 35-64 years with high-normal blood pressure

Objective To explore the distribution of the high-normal blood pressure(BP),and the association between high-normal blood pressure and cardiovascular risk in a Chinese cohort aged 35-64 years.Methods A prospective study was carried out in 11 provinces from 1992 to 2002.The association between baseline BP,cardiovascular risk factors and CVD(CHD and stroke) was analyzed in 30378 subjects aged 35-64 years.Results (1) The age standardized prevalence rate of high-normal BP was 32.2% in this population.The rate in males(34.2%) was significantly higher than that in females(30.2%).(2) In high-normal BP group,subjects with both SBP and DBP at high-normal BP level accounted for the majority(45%),subjects with only DBP at high-normal BP level had the lowest prevalence rate(20.1%).This trend was even more obvious with increasing age.(3) Compared with normal BP subjects,the high-normal BP subjects had higher level of cardiovascular risk factors.(4) After adjusting for age,sex,and other cardiovascular risk factors,the risk of CVD in subjects with high-normal BP increased by 49%,whereas the risk of stroke and CHD increased by 31% and 44% as compared with normal BP subjects,respectively.Conclusion The high-normal BP person had higher risk of CVD than normal person,the prevention and control of hypertension and CVD of this group should be enhanced.