父母高血压史与心血管病发病关系的前瞻性研究

A cohort study on parental history of hypertension and the risk of cardiovascular disease in Chinese population

目的探讨我国人群中父母高血压史与子代心血管病发病的关系。方法1992- 1994年在全国12组人群中分别整群随机抽取1000-2000人进行心血管病危险因素调查,并对心血管事件的发生情况进行随访观察,随访至2005年6月,平均随访10.8年。结果15 131例随访对象共发生心血管事件448例,其中冠心病事件82例,脑卒中事件370例,4例既发生冠心病事件又发生脑卒中事件。在控制了年龄、吸烟、饮酒后,男性和女性父母双方均无高血压史者、仅父母一方有高血压史者、父母双方均有高血压史者发生心血管病的相对危险分别为:男性:1.00,1.34(1.01-1.78), 2.58(1.62-4.11);女性:1.00,1.77(1.27-2.45),2.55(1.44-4.54)。在进一步控制了总胆固醇、高密度脂蛋白胆固醇、空腹血糖、体重指数和收缩压后,男性和女性上述各组发生心血管病的相对危险分别为:男性:1.00,1.01(0.76-1.35),1.72(1.07-2.75);女性:1.00,1.31(0.94-1.84),1.76 (0.98-3.15)。结论父母有高血压史者具有较高的发生心血管病的危险性,父母双方均有高血压史者心血管病发病危险的增加尤为显著。遗传因素对子代的影响在很大程度上是通过我们目前已知的危险因素而起作用。因而父母有高血压史者强化对传统的危险因素的控制,对于预防心血管病发病、提高生活质量可能具有更重要的意义。

Objective To assess the relationship between parental history of hypertension and the incidence of cardiovascular disease in Chinese populations. Methods A total of 15 131 individuals （7015 men and 8116 women, aged from 35 to 59 years） in China were enrolled and followed up from 1992 to 2005. The information on the parental history of hypertension of the participants was collected. The individuals were divided into three groups according to their parental history of hypertension： those without parental history of hypertension （ group 1 ） , those with one parent history of hypertension （ group 2） and those with beth parents history of hypertension （group 3）. The hazard ratio and its 95% confidence interval were calculated using the Cox proportional hazard model. Results There were 448 cardiovascular events （ including 82 cardiac events and 370 stroke events and 4 with beth cardiac and stroke events） during the 163 858 person-years of observation. After adjusting for age, smoking and drinking, the hazard ratio for cardiovascular disease for group 1, group 2 and group 3 were 1.00, 1.34 （1.01-1.78） , 2. 58 （ 1.62-4. 11 ） in men respectively and 1.00,1.77 （ 1.27-2. 45 ） ,2. 55 （ 1.44-4. 54） in women respectively. After further adjusting for serum total cholesterol （TC）, high density lipid cholesterol （HDL-C）, fasting glucose, body mass index （BMI） and systolic blood pressure （SBP） in the model, the hazard ratio for cardiovascular disease for those three groups were 1.00, 1.01 （0.76-1.35） , 1.72（ 1.07-2. 75） in men respectively and 1.00, 1.31（0.94-1.84）, 1.76（0.98-3.15） in women respoctively. Condusion The individuals with parental history of hypertension have a higher risk of cardiovascular disease, especially for those with beth oarents history of hypertension.