高收缩压轨迹是恶性肿瘤发生的危险因素

High level systolic blood pressure trajectories is the risk factor for cancer

目的探讨收缩压轨迹与恶性肿瘤发生的关系。方法收集54888名开滦(集团)有限责任公司职工2006—2007年、2008—2009年、2010—2011年3次健康体检的相关资料,及其恶性肿瘤新发情况。利用研究对象3次健康体检的血压测量值,进行收缩压轨迹分组。采用寿命表法计算恶性肿瘤发生率,并进行恶性肿瘤发病影响因素的多因素Cox比例风险模型回归分析。结果根据收缩压轨迹将54888人分为5组,其中低-稳定组14326人,正常-稳定组25630人,中-高组5390人,高-中组6438人,高-稳定组3104人。在(4.95±0.53)年的随访期内,共新发恶性肿瘤1070例。低-稳定组、正常-稳定组、中-高组、高-中组和高-稳定组的恶性肿瘤发生率分别为1.3%(177/14326)、2.2%(491/25360)、3.1%(147/5390)、2.7%(156/6438)和3.8%(99/3104),差异有统计学意义(P<0.001)。多因素Cox回归分析显示,校正性别、年龄、吸烟、饮酒、体育锻炼、体质指数、空腹血糖、总胆固醇、服用降压药、降糖药、降脂药后,收缩压轨迹与恶性肿瘤发病有关,与低-稳定组相比,正常-稳定组、中-高组、高-中组、高-稳定组的HR分别为1.413、1.731、1.557和1.907(均P<0.001)。结论高收缩压轨迹是恶性肿瘤发生的危险因素。

Objective To explore the effect of systolic blood pressure(SBP)trajectories on cancers.Methods The relevant data of 54,888 employees of Kailuan(Group)Limited Liability Company who participated in the 3 health examinations from 2006-2007,2008-2009,2010-2011 were collected and the new onset cancer cases were recorded.The systolic blood pressure trajectory grouping was carried out using the blood pressure measurement values of the 3 physical examinations.The life table method was used to calculate the incidence of cancer,and the multivariate Cox proportional hazard regression model was used to analyze the influence factors of cancer.Results According to the systolic blood pressure trajectory,54,888 subjects were divided into 5 groups,including 14,326 in the low-stable group,25,630 in the moderate-stable group,5,390 in the moderate-increasing group,6,438 in the elevated-lowering group,and 3,104 in the elevated-stable group.A total of 1,070 new onset cancer occurred during the follow-up period of(4.95±0.53)years.The incidence of cancer in the low-stable group,moderate-stable group,moderate-increasing group,elevated-lowering group and elevated-stable group were 1.3%(177/14,326),2.2%(491/25,360),3.1%(147/5,390),2.7%(156/6,438)and 3.8%(99/3,104),respectively,the difference was statistically significant(P<0.001).After adjusting for gender,age,smoking,drinking,physical exercise,body mass index(BMI),fasting blood glucose,total cholesterol,antihypertensive drugs,hypoglycemic drugs,and lipid-lowering drugs,multivariate Cox regression analysis showed that the systolic blood pressure trajectory was related to the incidence of cancer.Compared with the low-stable group,the Hazard ratio(HR)in the moderate-stable group,moderate-increasing group,elevated-lowering group and elevated-stable group were 1.413,1.731,1.557 and 1.907,respectively(all P<0.001).Conclusion High systolic blood pressure trajectories is the risk factor for cancer.