社区人群高血压类型与脑卒中发病关系研究

目的了解不同高血压类型与脑卒中发病之间的关系。方法收集年龄≥35岁社区人群的数据资料,对36836例基线调查时测得的血压与随访3 a监测的脑卒中发病情况进行相关分析,将新发脑卒中作为研究终点。结果高血压患病率约为23.9%;其中单纯收缩期高血压（ISH）患病率为11.1%,单纯舒张期高血压（IDH）为2.3%,混合型高血压（SDH）为10.5%。随访114339人年,共发生脑卒中事件356例,其中缺血性卒中240例,出血性卒中97例,未分类卒中19例,总脑卒中的发病率为311.4/10万人年。SDH组发生脑卒中的危险比其他组高,其发生总的脑卒中、缺血性卒中和出血性卒中的相对危险度及95%CI分别为3.03（2.20-4.15）、2.66（1.81-3.90）、3.09（1.67-5.69）。SDH组男性发生脑卒中的危险比女性高。结论ISH的患病率比IDH高,二者均会增加发生脑卒中的危险。SDH患者发生脑卒中的危险性最高,应该及时积极治疗。

Relationship between subtype hypertension and stroke in community population

Objective To observe the relationship between subtype hypertension and stroke.Methods The sample in this study included 36 863 people aged 35 years and over who came from a cohort of three communities.Baseline blood pressure was evaluated and its relationship with stroke was monitored during the 3-year follow-up period.First-ever stroke was considered as end-point event.Results The prevalence of hypertension was 23.9% in which isolated systolic hypertension（ISH） was 11.1%,isolated diastolic hypertension（IDH） was 2.3% , systolic and diastolic hypertension （SDH） was 10.5%. During a total of 114 339 person-years of follow-up, 356 persons caught stroke （240 cases ischemic, 97 cases hemorrhagic and 19 cases unclassified）. The cumulative incidence rate was 311.4 per 100 000 person-years. SDH patients were the highest risk to stroke among all the hypertensive patients. SDH was a stronger risk factor to stroke in men than in women. Conclusion The prevalence of ISH was higher than that of IDH in the population. ISH and IDH were both risk factors to stroke. SDH was the highest risk to stroke and should be treated in time.