摘要
背景:血压升高是代谢综合征(MetS)的表现之一,然而,各血压分类和高血压亚型与代谢综合征患病可能之间的关系尚未确定。方法:在1999—2002年国家健康和营养状况调查中选择了5968例年龄≥18岁、未经抗高血压治疗的受试者(加权为124700000)进行横断面研究,确定不同血压分类组的MetS(依据NCEP标准)患病可能性。根据JNC-VI血压分类,非高血压情况被分为理想血压、正常血压和高正常血压。
BACKGROUND: Elevated blood pressure(BP) is one element of metabolic syndrome(MetS); however, the relation of various BP categories and hypertension subtypes to the likelihood of having MetS is not well defined. METHODS: We determined the odds of MetS, defined by the National Cholesterol Education Program, in various BP categories from a cross-sectional study of 5968 individuals aged at least 18 years and untreated for hypertension(weighted to 124.7 million) in the National Health and Nutrition Examination Survey, 1999-2002. Nonhypertensive BP categories were optimal, normal, and high-normal BP, according to JNC-VI classification. Hypertension consisted of three subtypes: isolated diastolic hypertension(IDH), systolic-diastolic hypertension(SDH), and isolated systolic hypertension(ISH). RESULTS: Among those with hypertension and MetS, 25.3%had IDH, 20.2%had SDH, and 54.5%had ISH. The MetS prevalence in nontreated persons was 5.8%for optimal BP, 9.1%for normal BP, 38.2%for high-normal BP, 45.9%for IDH, 44.3%for SDH, and 43.9%for ISH. Risk factor odds ratios(95%confidence intervals; reference group, optimal BP), adjusted for age, sex, total cholesterol, and smoking, were 1.6(1.2-2.2) for normal BP, 9.4(6.9-12.7) for high-normal BP, 14.7(8.9-24.0) for IDH, 12.2(7.2-20.8) for SDH, and 10.2(7.0-14.9) for ISH(all P< 0.01); odds ratios were higher for women in all categories. CONCLUSIONS: Despite having the lowest mean age, IDH subtype is associated with greatest likelihood of MetS. The high frequency of ISH in the hypertensive population, however, makes ISH the most common hypertensive subtype in persons with MetS.
