高血压患者十年脑卒中风险概率分析

目的分析徐州市中心医院高血压患者十年脑卒中发病风险概率。方法收集2011年11月至2012年4月徐州市中心医院1861例心内科门诊及住院高血压患者的病例资料，排除既往有脑卒中病史及现在新发脑卒中者。将就诊时陛别、年龄、血压水平以及合并糖尿病、心血管疾病、房颤等指标，按照弗雷明汉风险评分（Framingham risk score，FRS），计算得出十年脑卒中风险概率，并对上述指标进行相关分析。结果①1861例高血压患者中男性967例，女性894例，平均年龄（60．78±12．79）岁，平均收缩压（143．12±16．31）mmHg，平均舒张压（81．37±12．56）mmHg。十年脑卒中风险概率评估发现低危者为27．35％，中危者为21．60％，其中高危者为51．05％，所占比率最高（P〈0．05）。②年龄〈54岁时高血压发病率男性较女性高（P〈0．05），女性血压轻度升高者较男性比率高（P〈0．05）。随着年龄的增长，无论男女十年脑卒中风险概率均持续升高。男性高危者（64．53％）居多，而在女性人群中低危者（43．85％）比率最高。71岁之前男性十年脑卒中发生风险高于女性，但是71岁后两者之间无明显差异。③高血压患者脑卒中一级预防相关危险因素糖尿病、心血管疾病、房颤、左心室肥厚的患病率随着年龄的增加呈现增加的趋势。结论在脑卒中的一级预防中，综合评估并干预各种危险因素，采取积极有针对性的预防卒中策略，其中控制高血压是预防脑卒中的关键。

Survey on the lO-year probability of stroke for hypertension

Objective The purpose of this study was to investigate the lO-year probability of stroke in hypertension patients. Methods Patients with hypertension who had visited the Central Hospital of Xuzhou from November 2011 to April 2012 were included in this epidemiologic survey. Exclusion criteria included the subjects who had history of stroke or recent stroke. Data on sex, age, blood pressure level, diabetes, cardiovascular disease, atrial fibrillation and other complicated diseases were collected. The 10-year probability of stroke was determined by applying the Framingham stroke risk equation. These parameters were evaluated using correlation analysis. Results （~） Total of 1861 patients with hypertension were enrolled, including 967 male and 894 female. Mean age was （60.78 _＋ 12.79） years. Mean systolic blood pressure was（ 143.12 ＋ 16.31 ）mm Hg （ l mm Hg = 0. 133 kPa）. Mean diastolic blood pressure was （81.37 -＋ 12.56）mm Hg. Hypertension patients at low stroke risk in 10 years were 27.35% , at moderate risk were 21.60% and at high risk were 51.05%, which was the highest proportion （ P 〈 O. 05 ）. （~） The incidence of hypertension was higher in the male population than female of persons younger than 54 years （ P 〈 0.05）. The ratio of mild elevation of blood pressure in female was higher than male （ P 〈 O. 05）. An increased stroke risk was due to elevated levels of age. The proportion of high risk in mate was 64.53% and the proportion of low risk in female was 43.85%. The stroke risk of male was higher than female before age of 71 years and after it there was no difference. （~） The primary prevention of stroke associated risk factors which included diabetes, cardiovascular disease, atrial fibrillation and left ventricular hypertrophy were positively correlated with age among the patients with hypertension. Conclusions Primary prevention of stroke requires identification information of patients and comprehensive intervening risk factors. Effective management of hypertension plays an important role in the primary prevention of stroke.