正常血压高值人群缺血性心血管疾病发生风险的评估分析

Risk Assessment of Ischemic-cardiovascular Diseases in People with High-normal Value of Blood Pressure

目的对正常血压高值人群其未来缺血性心血管疾病(ICVD)发病风险进行评估分析。方法以2017年成都市社区常住人口为调查对象,按不同血压分组统计,分为理想血压组、正常血压高值组与高血压组,对每组人群ICVD发病相关的一般情况以及代谢指标进行检测分析,并分组进行ICVD发病风险评估。结果4802例有效调查人口中,共检出正常血压高值人群1140例,检出率为23.7%(标准化检出率为27.4%),其中男性43.8%(500例),女性56.2%(640例)。正常血压高值组与理想血压组比较,有多组危险因素暴露率增高,包括超重或肥胖,吸烟;以及多组代谢异常血症增多,包括单纯脂代谢异常血症、高胆固醇血症、高甘油三酯血症和混合型高脂血症,其差异有统计学意义(P<0.05)。按国人10年ICVD发病危险度评分显示正常血压高值组评分低于高血压组,但明显高于理想血压组,差异有统计学意义(P<0.05)。结论正常血压高值人群相较于理想血压人群存在更高的代谢紊乱比例,以及其他相关的危险因素暴露率,这种现象加大了其未来ICVD的发病风险。所以对正常血压高值人群的健康防控工作除了需考虑对其血压情况的监控,还需增加对其代谢异常,以及其他ICVD相关危险因素的监控,根据ICVD评分情况考虑是否进行提前干预,以降低这一区间人群未来ICVD的发病风险。

Objective To evaluate and analyse the risk of ischemic-cardiovascular diseases(ICVD)among people with high-normal value of blood pressure.Methods Based on the residential community population in Chengdu in 2017 and different group statistics of blood pressure,respondents were divided into ideal blood pressure group,high-normal blood pressure group and hypertension group.Each group s general situation and metabolic markers of ICVD were detected and analyzed,and the risk assessment of ICVD were conducted in groups.Results In the 4802 investigated population,1140 of respondents were identified high-normal value of blood pressure,the detection rate was 23.7%(the standardized detection rate was 27.4%).In this investigation,the detection rate in male was 43.86%(500 cases),female was 56.14%(640 cases).Comparing high-normal blood pressure group with ideal blood pressure group,the exposure rate of multiple risk factors increased,including obesity/overweight,smoking and the multiple metabolic disorders increased,including simple dyslipidaemia,hypercholesterolemia,hypertriglyceridemia and mixed hyperlipidaemia.The differences have statistical significance(P<0.05).According to the risk score of ICVD in the past 10 years in China,the score of high-normal blood pressure group was lower than that of high blood pressure group,but significantly higher than that of ideal blood pressure group.The differences have statistical significance(P<0.05).Conclusion Compared with the ideal blood pressure group,the high-normal blood pressure group has a higher proportion of metabolic disorders and other related risk factors exposure rate.This phenomenon increases the risk of ICVD in the future.Therefore,in addition to the monitoring of blood pressure,the health prevention and control of people with high-normal blood need to increase the diagnosis and intervention of metabolic abnormalities and other risk factors related to ICVD.Early intervention should be considered according to ICVD score,which reduces the risk of ICVD among this group in the future.