收缩压及舒张压与脑卒中和冠心病关系的前瞻性研究

Comparsion of the SBP or DBP in incidence of Cardio-,Cerebral-Vascular Events:A Cohort Study in 11 Provines of China

目的研究收缩压及舒张压与脑卒中、冠心病发病的关系及作用强度。方法 :采用前瞻性队列研究的方法 ,11省市 35～ 6 4岁男女两性 2 9,488人于 1992年进行基线调查 ,随访 3年 ,其中 12 ,76 2人继续随访 7年 ,在随访期间发生的心血管病事件进行登记。对不同收缩压及舒张压水平与心血管病发病的关系进行统计学分析。结果 :(1)该人群高血压患病率为 2 5 .8% (75 97/2 9488) ,其中收缩压和舒张压均增高者占 5 6 .4% (4 2 82 /75 97)单纯收缩压增高者占 11.5 % (873/75 97)单纯舒张压增高者占 32 ,2 %(2 44 3/75 97) ;(2 )随访期间共发生急性冠心病事件 12 2人 ,脑卒中事件 30 4人 ,其中缺血型脑卒中占 6 4.8% (198/30 4) ,出血型脑卒中占 2 8.0 % (85 /30 4) ,未分型脑卒中占 7.2 % (2 2 /30 4) ;(3)交叉分层分析血压水平与心血管病发病的关系。在同一舒张压水平 ,随着收缩压水平的升高脑卒中事件和急性冠心病事件的发病危险增加 ,其变化趋势有统计学的显著意义 (P <0 .0 0 1) ;在同一收缩压水平 ,随着舒张压水平的升高脑卒中事件发病危险增加 ;而冠心病则不明显 ;(4 )随访期间发生的心血管病事件中 ,6 9,4%的脑卒中、5 6 .6 %的急性冠心病发生在高血压患者中。结论 :在我国 35～ 6 4岁人群中 。

Objective:To examine that if there are some differences for SBP and DBP in the strength of association with CVD events. Methods: There were 29488 patients included male and female aged 35～64 in the baseline survey of a prospective study established in 11 province of China from 1992. The averaged years of following up was 4.7 years. All the CVD events occurred during the period of following up(1992 to 1999) were registed. The statistical analysis were done in the association of CVD events with patients' SBP and DBP. Results:(1)The prevalence rate of hypertension was 25.8%(7579/29488). The hypertension in which both SBP and DBP increases accouted for 56.4%;the high SBP is 11.5%,and only high diastolic is 32.3%.(2)There were totally 122 acute coronary events and 304 acute stroke events.(3)According the DBP level,the SBP and DBP were classified into three strata respectively. The associations between differents strata and CVD risk were analysed. At the same level of DBP,the risk of acute stroke events and the risk of acute coronary event increased as the increase of SBP(trend test P< 0 001).At the same SBP level ,the risk of acute stroke events increased as the increase of DBP,but this combination is not true in acute coronary events.(4)Among the CVD events,69.4% stroke events and 56.6% coronary events came from the population of hypertension. Conclusion: In Chinese population, both high SBP and DBP increases the risk of stroke. The association of SBP and coronary events is remarkable than that for DBP.