血浆同型半胱氨酸与高血压关系的回顾性队列研究

A Retrospective Cohort Study on the Relationship Between Plasma Homocysteine and Hypertension

目的探讨基线血浆同型半胱氨酸(Hcy)水平与高血压的关系。方法选取2014年1月~12月我中心于新疆额敏县通过多级分层随机抽样方法选取的≥15岁人群中的非高血压人群,按照基线Hcy水平三分位分为三组(T1组、T2组、T3组),随访5年,绘制累积KM曲线,比较三组高血压发病风险,利用多因素COX比例风险回归探讨Hcy与高血压的关系。结果共有1352人纳入研究,平均年龄(48.67±13.67)岁,男性占41.42%,女性占58.58%;T1组、T2组、T3组年龄、基线收缩压水平依次升高,叶酸水平逐级下降,男性、饮酒者比例依次增大,组间差异有统计学意义(P<0.05);中位随访4.8年后,T1组、T2组、T3组高血压发病风险依次升高,组间差异有统计学意义(P<0.05);多因素COX回归分析显示,在校正相关危险因素后,高Hcy与高血压发生风险增加有关,以T1组为对照,T2组和T3组高血压的发生风险分别是T1组的1.20倍(95%CI:0.90~1.59)和1.64倍(95%CI:1.23~2.19)。结论高血浆同型半胱氨酸水平是高血压发生的独立危险因素,降低血浆同型半胱氨酸水平可能是高血压防治的有效途径之一。

Objective To investigate the relationship between baseline plasma homocysteine(Hcy)level and hypertension.Methods From January to December 2014,non-hypertensive people among people≥15 years old selected by our center in Emin County,Xinjiang by multi-level stratified random sampling method,were divided into three groups according to the tertile of baseline Hcy level(T1 Group/T2 group/T3 group),followed up for 5 years,draw cumulative KM curve,compare the risk of hypertension in the three groups,use multi-factor COX proportional hazard regression to explore the relationship between Hcy and hypertension.Results A total of 1352 people were included in the study,with an average age of(48.67±13.67)years old,41.42%of men and 58.58%of women;The age and baseline systolic blood pressure level in the T1 group,T2 group,and T3 group increased successively,the level of folic acid gradually decreased,and the proportion of men and alcohol drinkers increased successively,the difference between the groups was statistically significant(P<0.05);After a median follow-up of 4.8 years,the risk of hypertension in the T1,T2,and T3 groups increased in turn,and the difference between the groups was statistically significant(P<0.05);Multivariate COX regression analysis showed that after adjusting for related risk factors,high Hcy was associated with an increased risk of hypertension.Taking the T1 group as a control,the risk of hypertension in the T2 and T3 groups was 1.20 times(95%CI:0.90~1.59)and 1.64 times(95%CI:1.23~2.19)that of the T1 group,respectively.Conclusion High plasma homocysteine level is an independent risk factor for hypertension.Lowering plasma homocysteine level may be one of the effective ways to prevent and treat hypertension.