血压的各种指标对中老年人心脑血管病死亡事件的预测价值

The Predictive Value of Blood Pressure-variables for Long-Term Cardio-Cerebrovascular Mortality in Middle and Old age Population

目的探讨中、老年人收缩压(SBP)、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)水平对远期心脑血管死亡事件预测价值的差异。方法对中老年人群10786例进行基线调查,随访8年,应用Cox回归分析4个血压指标对远期心脑血管死亡事件预测价值的差异。结果校正其他因素后,MAP和SBP分别为中、老年人最强烈的预测远期心脑血管病死亡事件危险程度的血压指标。中老年人4个血压指标每升高1个标准差(SD),其发生心脑血管病死亡危险的相对危险度(RR)由高到低分别为:(1)中年组:MAP(1.837),SBP(1.782),DBP(1.775),PP(1.750);(2)老年组:SBP(1.345),MAP(1.343),DBP(1.219),PP(1.215)。结论4个血压指标对心脑血管死亡事件的预测在不同的年龄段是不同的。中年人应着重于总体血压的控制,老年人应首先控制SBP。

Objective To explore systolic blood pressure（SBP）, diastolic blood pressure（DBP）, pulse pressure（PP）, and mean arterial pressure（MAP） in predicting the risk of long-term eardio-eerebrovaseular mortality in middle and old age population. Methods The baseline survey in a cohort of 10 786 peoples of middle-old age was carried out in the year 1991. The predictive value the four blood pressure variables for eardio-eerebrovaseular mortality was analyzed by using Cox regression model. Results Three hundred ninety five cardio-cerebrovascular death events occurred during 8 years follow-up. After adjusted other risk factors, MAP was the strongest predictive factor for cardio-cerebrovascular mortality in middle-aged population, however, SBP is the most significant determinant predicting the cardio-cerebrovascular mortality in senile people with 1-SD increment for each blood pressure index, adjusted relative risks （RR） for cardio-cerebrovascular mortality were 1. 837 for MAP, 1. 782 for SBP, 1. 775 for DBP, 1. 750 for PP in middle-aged group and 1. 345 for SBP, 1. 343 for MAP, 1. 219 for DBP and 1. 215 for PP in senile group. Conclusion The predictive values of the four blood pressure variables were different in different age stages. MAP should be controlled primarily in middle-aged population, while SBP is the strongest predictive risk factor for the senile population.