老年人血压水平与冠心病和脑卒中发病关系的研究

目的探讨老年人血压水平与冠心病和脑卒中的发病关系。方法1993年抽样调查社区60岁及以上老人3440例,随访11年,排除基线已患有冠心病或脑卒中者及失访老人,对2 398例研究样本进行研究,其中高血压组1 424例,血压正常组974例。分析基线不同血压组别及不同血压水平与新发冠心病和脑卒中的关系。结果该人群基线高血压组新发冠心病16．9％,脑卒中15．4％,发病率明显高于血压正常组(发病率分别为13．2％,10．1％);且冠心病和脑卒中的发病率均随基线收缩压或舒张压水平的升高而升高;在相同血压水平女性老年人的冠心病发病率高于男性;多因素分析显示,冠心病和脑卒中发病与收缩压水平有关;低龄老人较高龄老人心、脑血管疾病发病率高。结论收缩压是冠心病和脑卒中发病的独立危险因素,积极防治老年收缩期高血压有助于减少冠心病和脑卒中的发病,尤其对低龄老人。

A study on relationship between blood pressure level and incidence of stroke and coronary heart disease in aged

Objective To study the relationship between blood pressure(BP)level and incidence of stroke and coronary heart disease (CHD) in aged in Beijing. Methods In 1993, a cohort of 3 440 community people above 60 years old was selected in Beijing. The group of 2 398 aged people divided into hypertension(Hp) group and non-Hp group was followed-up in 1997, 2000 and 2004, excepting the missing people, the baseline CHD and/or stroke patients. Results The incidences of CHD and stroke were higher in Hp group compared with non-Hp group and they increased with rising of the baseline SBP and DBP levels. CHD incidence was higher in females than in males before 75 years old. SBP level was related to CHD and stroke by logistic analysis . Meantime, CHD and stroke were more apt to occur in young elderly than in old elderly. Conclusions Systolic blood pressure level can be considered as an independent risk factor for CHD and stroke in aged. The incidences of stroke and CHD can be reduced by controlling BP to normal value, especially for young elderly.