2186例老年高血压患者心血管事件的危险因素分析

Risk factors of cardiovascular events in 2186 elderly patients with hypertension

目的探讨老年高血压患者心血管事件的危险因素,为临床制订预防措施提供依据。方法选取2008年1月-2012年12月八一总场医院和儋州市人民医院收治的老年高血压患者2 186例,根据是否发生心血管事件分为心血管事件组(985例)和无心血管事件组(1 201例)。应用单因素分析及多因素Logistic回归分析老年高血压患者心血管事件的危险因素,并应用ROC曲线评价Logistic回归模型的效果。结果心血管事件组与无心血管事件组的性别(男/女:592/393 vs 700/501)、年龄(79.14±10.62 vs 76.38±10.25)差异均无统计学意义(P均>0.05)。在2 186例老年高血压患者中发生心血管事件985例,发生率为45.1%。单因素及多因素分析显示,收缩压[OR(95%CI):2.206(1.162~3.207)]、低密度脂蛋白(low density lipoprotein,LDL)[OR(95%CI):4.614(3.812~7.506)]、总胆固醇(total cholesterol,TC)[OR(95%CI):2.625(1.308~4.035)]、三酰甘油(triglyceride,TG)[OR(95%CI):2.953(1.537~4.632)]、尿酸(uric acid,UA)[OR=3.205(95%CI):(1.864~5.837)]、纤维蛋白原(fibrinogen,FIB)[OR(95%CI):3.827(2.316~6.118)]及同型半胱氨酸(homocysteine,Hcy)[OR(95%CI):6.218(4.369~10.813)]是老年高血压患者心血管事件的独立危险因素。ROC曲线评价Logistic回归模型效果,其AUC(95%CI)为0.948(0.885~0.993)。结论 LDL、TC、TG、UA、FIB及Hcy水平升高是本组心血管事件的独立危险因素。

Objective To explore the risk factors of cardiovascular events in elderly patients with hypertension and provide measures for early prevention. Methods From January 2008 to December 2012, 2 186 elderly patients with hypertension in Bayi Farm Hospital and Danzhou People＇s Hospital were selected and divided into cardiovascular event group （n=985） and non-cardiovascular events group （n=1 201） according to the occurrence of cardiovascular events. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of cardiovascular events in elderly hypertensive patients, and the power of the effect of logistic regression model was evaluated by ROC curve. Results There was no statistically significant difference in sex （male/female： 592/393 vs 700/501） and age [ （79.14±10.62） years vs （76.38±10.25） years] between the two groups （all P 〉0.05）. The incidence of cardiovascular events was 45.1% （985/2186）. Univariate and multivariate analysis showed that systolic pressure （OR： 2.206; 95%CI ： 1.162-3.207）, low density lipoprotein （LDL） （OR ： 4.614; 95%CI ： 3.812-7.506）, total cholesterol （TC） （OR ： 2.625; 95%CI ： 1.308-4.035）, triglyceride （TG） （OR ： 2.953; 95%CI ： 0.537-4.632）, uric acid （UA） （OR, 3.205; 95%CI, 1.864-5.837）, fibrinogen （FIB） （OR ： 3.827, 95%CI ： 2.316-6.118）, and homocysteine （Hcy） （OR ： 6.218; 95%CI ： 4.369-10.813） were independent risk factors for cardiovascular events in elderly patients with hypertension. Conclusion The incidence of cardiovascular events is high in elderly hypertensive patients, and elevated levels of LDL, TC, TG, UA, FIB and Hcy are independent risk factors for cardiovascular events.