高血压病人长期预后观察(17年随访研究)

Long-term Prognosis of Hypertension (A 17 Years′ Follow-up Study)

以 17年前年龄在 35～ 6 0岁确诊为高血压的 2 36个病人作为研究对象 ,并随机选择地区、年龄、性别、职业相配对的非高血压健康人作为对照 ,随访研究高血压病人的长期预后。发现本地区高血压病人的主要并发症和死亡原因是脑卒中 (90 .0 % ,41.7% ) ,高血压病人脑卒中的发生率是 18.5 /10 0 0人年 ,相对危险度 (RR)是正常人的 7.76倍 ,特异危险度百分比 (AR% )为87.11%。高血压脑卒中死亡率是 12 .9/10 0 0人年 ,RR为 9.39,AR为 89.35 %。本组高血压病人的血清胆固醇平均值低于西方国家人群水平 ,可能是造成这组高血压病人脑卒中发生率和死亡率较高的原因之一。

To study the long term prognosis of hypertension in the rural areas,236 patients with established hypertension of 35 to 60 yrs were followed up for 17 years.A cohort of normotensives strictly matched with age,sex,region and occupation served as controls (1∶1).It was found that stroke rather than CHD events,was the main complication (90.5%) and cause of death(41.7%) in hypertensives in this study.The relative risk(RR) of occurrence and death of stroke were 7.76 and 9.39.The attributable risk percentages (AR%) of occurrence rate and death rate of stroke were 87.11% and 89.35%,respectively.The incidence of stroke was 18.5/1000 person year and the mortality rate of stroke was 12.9/1000 person year.The serum level of cholesterol in both patients with hypertension and those who died of stroke was little higher (P>0.05) than that in normotensive controls but significantly lower than that in western population.It is postulated that the lower level of cholesterol may contribute to the higher morbidity and mortality of stroke in this study.