动态脉压对正常血压老年男性心脑血管危险的预测作用

Effect of dynamic pulse pressure on predicting cardiovascular risk of old men with normotension

目的探讨动态脉压对血压正常的老年男性心脑血管危险的预测作用。方法对1995年5月～2001年9月858例血压正常的老年男性进行动态血压监测,其年龄为72.7±8.9(60～91)岁,观察期2.2±1.5(0.4～5.3)年,调查记录首次发生的主要心脑血管事件。结果发生心脑血管事件的患者动态脉压高于未发生者(56.0±8.2mmHgvs51.7±9.8mmHg,P<0.001)。在动态脉压≤45mmHg、46～60mmHg和>60mmHg三组中,心脑血管事件的发生率(事件数/100人年)依次增高,分别为3.7、5.8和9.1,Logrank单因素分析P值分别为0.0009、0.0002、0.0000。Cox多因素分析显示,动态脉压对心脑血管事件具有独立的预测价值(P<0.01)。结论对血压正常的老年男性,动态脉压仍是独立的心脑血管危险预测因子。

Objective To explore the possibility of dynamic pulse pressure （DPP） being used to predict cardiovascular events in old men with normotension. Methods During May 1995 to September 2001, a 24h DPP monitoring was carried out on 858 old men with normotension （60-91 years old, BP〈140/90mmHg） with the monitoring period from 0. 4 to 5.3 years. All the subjects were divided into 3 groups based on their DPP： ≤45mmHg, 46-60mmHg and 〉60 mmHg, respectively. The first attack of cardiovascular event was recordeck Results In the 3 groups of subjects, the incidence of total cardiovascular events （100 persons per year） was 3.7, 5. 8, and 9. 1 respectively （log-rank test, P=0. 000 9, 0. 000 2, 0. 000 0）. After adjustment for the other risk factors including age, hypertension history, diabetes and previous cardiovascular disease, it has been found that the data of dynamic pulse pressure is of a significant value for predict cardiovascular events （P〈0. 01）. Conclusion Dynamic pulse pressure is an independent predictor of cardiovascular risk in old men with normotension.