中老年人脉压与脑卒中危险的相关性

Pulse Pressure and Stroke

目的回顾性研究中、老年人脉压与脑卒中发病的关系及差异。方法对15752例年龄≥40岁的高血压普查人群进行血压测量和登记,统计分析方法采用t检验,χ2检验及二值多元Logistic回归分析。结果15752例人群中,检出脑卒中患者282例(1.8%),非脑卒中患者15470例(98.2%)。脉压平均为(47.5±11.1)mmHg。脉压随年龄的增长而升高,70岁左右达到最高峰,此后女性脉压较为平稳,男性脉压则略有下降。调整血压以外的其他因素(年龄、性别、体重指数、吸烟、饮酒、冠心病史、高胆固醇血症、糖尿病等)后,随PP水平的增高,中老年人群脑卒中患病率也随之增加。调整血压以外的其他因素后,脉压每增加10mmHg,中、老年人脑卒中危险分别增加76.0%、44.8%。校正收缩压后,脉压与中年人脑卒中呈显著负相关(B=-0.482,OR=0.618,P<0.01),与老年人脑卒中则无显著相关性;校正舒张压后,中老年人脉压与脑卒中仍显著正相关。结论中老年人群脑卒中的患病率随脉压水平的升高而增加。中年人应首先重视舒张压的控制;老年人应在降低血压的同时,尽量降低脉压水平。

Objective To retrospectively investigate the association between pulse pressure（PP） and incidence rate of stroke by age. Methods Datas from Shandong BP survey involved 15 752 subjects aged over 40 in 2002. The association between PP and risk of stroke was analysed with t-test, X^2 test and binary logistic regression. Results 15 752 participants were recruited in this study, including 282（1.8%） subjects with history of stroke. The average level of PP was 47.5±11.1 mm Hg. With the increase of age, the level of PP rised and reached the peak value at about 70 years old. After adjusting age, gender, body mass index, smoking, alcohol drinking, coronary heart disease, hypercholesteremia, diabetes, the incidence of stroke increased with the increase of PP. With each increase of 10 mm Hg of PP, the stroke risk was increased by 76.0% in the middle-aged and 44. 8% in the senile population. After adjustment for systolic blood pressure（SBP）, the association between PP and stroke was inversely related in middle-aged population（ B= -0. 482, OR= 0.618, P〈0.01 ）, but not significant in senile population. Conclusion The incidence of stroke was elevated for the subjects with high PP in middle-aged and senile population. The association between PP and stroke was independent of DBP, but related to SBP.