中老年原发性高血压病患者脉压与心脑血管事件的相关性分析

Correlation analysis of pulse pressure with cardiac-cerebral vascular events in middle-aged and elderly patients with primary hypertension

目的对中老年原发性高血压病患者进行长期临床观察,分析收缩压、舒张压、脉压与心脑血管事件的相关性。方法确诊的原发性高血压病患者400例,每半年至少随访1次,观察期为3年。每次随访测坐位血压、血糖、同步胰岛素、血脂、肾功能及进行心电图和超声心动图等检查,以发生心脑血管事件作为观察终点。采用单因素Logistic回归和多因素逐步Logistic回归,进行发生心脑血管事件的因素分析。结果原发性高血压病患者发生心脑血管事件与年龄大、收缩压高、舒张压低、脉压宽等因素有关(P值均<0.05)。脉压每增加10mmHg(1mmHg=0.133 kPa),终点事件发生率增加2.5倍,为10.8%。脉压≥80mmHg患者的心脑血管事件发生率达28.57%,是心脑血管事件的独立预测因子。结论脉压≥80mmHg是心脑血管事件的一个重要的独立危险因子。

Objective To analyze the association of blood pressure （BP, including systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP]） and cardiac-cerebral vascular events in the middle aged and elderly patients with primary hypertension by long observation, Methods Four hundred hypertensive patients were followed up at least once half a year for 3 years. The BP at sitting position, serum glucose, serum insulin, serum lipid, renal function, electrocardiogram and ultrasonic cardiography were examined during followup. The primary end point was the occurrence of cardiac-cerebral vascular events. Logistic regression and multiple factors logistic regression analysis were used to analyze the risk factors of cardiac-cerebral events. Results Elder age, higher SBP, lower DBP, and wider PP were the risk factors of cardiac-cerebral vascular events in hypertensive patients （all P〈0.05）. A 10 mmHg （1 mmHg=0. 133 kPa） wider PP would increase the incidence of cardiaccerebral vascular events by 2. 5 folds, with the incidence being 10.8%. If PP≥80 mmHg, the incidence would be 28.57M, so PP was an independent predictor of cardiac-cerebral vascular events. Conclusion The study shows that PP is an important independent risk factor of cardiac-cerebral vascular events.