改良的心血管健康行为和因素评分与老年人短时收缩压变异性的关系

Relationship Between Improved Cardiovascular Health Behavior Score and Short-time Systemic Blood Pressure Variability in Elder Population

目的：探讨改良的美国心脏协会（AHA）心血管健康行为和因素评分对开滦研究中部分老年人群短时收缩压变异性（SBPV）的影响。方法：抽取开滦总医院、开滦林西医院、开滦赵各庄医院离退休职工中年龄≥60岁、无心脏瓣膜病、心肌病、频发早搏、心房颤动、房室及室内传导阻滞等疾病,2周内未服用抗精神病药物、帕金森治疗药物、抗抑郁症药物及镇静止痛药物者2 464例组成研究队列,进一步行24 h动态血压监测。采用24 h、日间和夜间收缩压标准差作为24 h、日间和夜间SBPV。用多元线性回归分析改良的心血管健康行为和因素评分对24 h、日间和夜间SBPV的影响。改良的心血管健康行为和因素是指：将2010年AHA提出的7项指标中的蔬菜摄入量改为食盐摄入量;体重指数（BMI）界限值采用《中国成人超重和肥胖症预防控制指南》提出的中国成人超重和肥胖BMI界限值参考标准;有关运动的定义也与AHA的定义略有不同,本研究采用的标准为理想运动量≥80 min/周,一般为〈80 min/周,差为从不运动。结果：最终纳入分析的研究对象1 812例,按改良的心血管健康行为和因素评分分组：第一组（0-4分,n=56）、第二组（5-9分,n=1 600）、第三组（10-14分,n=156）;三组对应的24 h、日间和夜间SBPV分别为16.02 mmHg（1 mmHg=0.133 kPa）、14.91 mmHg和13.18 mmHg,15.42 mmHg、14.50 mmHg和13.22 mmHg,12.68 mmHg、11.44mmHg和10.16 mmHg（P均〈0.05）。多元线性回归分析显示,校正混杂因素后,改良的心血管健康行为评分每增加1分,24 h、日间和夜间SBPV分别降低0,20 mmHg、0.19 mmHg和0.37 mmHg（P均〈0.05）。结论：改良的心血管健康行为和因素评分与老年人短时SBPV呈明显的负相关关系。

Objective： To investigate the impact of improved AHA cardiovascular health behavior score （CHS） on short-timesystemic blood pressure variability （SBPV） in elder population. Methods： A total of 2464 participants 〉_ 60 years from 3 hospitals of Kailuan area were taken for cohort study. The participants had no cardiovascular disease, not taking anti-psychotic drug, Parkinson treatment drug, anti-depression drug and analgesic drug within 2 weeks. All participants received 24-hour ambulatory blood pressure monitoring （ABPM） and the 24-hour, day-time, night-time SBPV were defined by the standard deviation of 24-hour, day-time, night-time systolic blood pressure. The influence of CHS on SBPV was studied by multi-linear regression analysis. Improved cardiovascular health behavior and factors implied as changing the vegetable intake amount to salt amount by American Humane Association, 2010; boundary of BMI based on 《Guidelines for prevention of overweight and obesity in Chinese adults》; status of exercise wasdefied as the ideal status： 〉80 mirdweek, general status： 〈 80 rain/week and bad status： no exercise. Results： Finally, 1812 participants were recruited for survey and they were divided into 3 groups according to improved CHS： G-roup①, CHS （0-4） points, n=56, Group②, CHS （5-9） points n=1600 and Group③, CHS （10-14） points, n=156. The 24-hour SBPV in Groups ①, ②and ③ were 16.02 mmHg, 14.91 mmHg and 13.18 mmHg; day-time SBPV were 15.42 mmHg, 14.50 mmHg and 13.22 mmHg; night-time SBPV were 12.68 mmHg, 11.44 mmHg and 10.16 mmHg, all P〈0.05. Multi- linear regression analysis indicated that with adjusted confounding factors, with 1 point of CHS elevation, the 24 hour-, day- time, night-time SBPV would reduce for 0.20 mmHg, 0.19 mmHg and 0.37 mmHg respectively, all P〈0.05. Conclusion： CHS was negatively related to short-time SBPV in elder population.