中老年人臂间收缩压差异与颈动脉斑块的关系

Relationship between inter-arm systolic blood pressure difference and carotid artery plaque in middle-aged and elderly adults

目的探讨中老年人臂间收缩压差异(sIAD)与颈动脉斑块的关系。方法此研究为横断面研究设计,根据抽样标准在2006-2007年参加健康体检的开滦集团职工101510人中取5816人(年龄≥40岁)作为观察对象,其中参加了2010-2011年体检并符合入选标准、有完整的双臂血压、颈动脉超声资料的5011人最终纳入统计分析。采用同时测量卧位双臂血压的方法计算双臂收缩压差值的绝对值(sIAD),并分为sIAD<10和≥10 mm Hg两组,分析sIAD与颈动脉斑块的关系。结果sIAD<10、≥10 mm Hg组颈动脉斑块的检出率分别为42.0%和47.3%(χ^(2)=4.89,P=0.03),其中年龄40~<60岁人群中sIAD<10、≥10 mm Hg组颈动脉斑块检出率分别为28.3%、37.1%(χ^(2)=12.19,P<0.01),年龄≥60岁人群中分别为77.6%、82.9%(χ^(2)=1.59,P=0.21)。多因素logistic回归进一步分析显示,在校正混杂因素后,sIAD≥10 mm Hg与颈动脉斑块发生相关(OR=1.33,95%CI 1.06~1.67)。年龄40~<60岁亚组人群sIAD≥10 mm Hg组出现颈动脉斑块的OR值(95%CI)为1.31(1.01~1.68);年龄≥60岁亚组人群sIAD≥10 mm Hg组出现颈动脉斑块的OR值(95%CI)为1.48(0.84~2.62)。结论年龄40~<60岁人群中sIAD≥10 mm Hg与颈动脉斑块相关。

Objective To explore the relationship between inter-arm systolic blood pressure difference(sIAD)and carotid artery plaque in middle-aged and elderly adults.Methods Cross-sectional design was applied in the study.Using a random stratified sampling method,a total of 5816 subjects aged 40 and over were selected from 101510 workers in Kailuan Group who participated in the health examination from 2006 to 2007.Subsequently,5011 subjects who met the inclusion criteria and had complete data(regarding blood pressure on both arms and carotid ultrasound)in 2010-2011 were included in final analysis.Simultaneous systolic blood pressure measurements of both arms were recorded to calculate sIAD.The subjects were divided into sIAD<10 and≥10 mm Hg group.And the relationship between sIAD and carotid artery plaque were analysed.Results The detection rate of carotid artery plaque was 42.0%and 47.3%in the sIAD<10 and≥10 mm Hg group,respectively(χ^(2)=4.89,P=0.03).In the subjects aged 40-<60 years,the detection rate of carotid artery plaque in sIAD<10 and≥10 mm Hg group was 28.3%and 37.1%(χ^(2)=12.19,P<0.01)respectively.And in the subjects aged 60 and above,the rate was 77.6%and 82.9%,respectively(χ^(2)=1.59,P=0.21).Multiple logistic regression analysis showed that sIAD≥10 mm Hg was an independent risk factor of carotid plaques(OR=1.33,95%CI 1.06-1.67)after adjusting for confounding factors.In the subjects aged 40-<60 years,the OR of carotid plaque with sIAD≥10 mm Hg was 1.31(95%CI 1.01-1.68).In the subjects aged 60 and above,which was 1.48(0.84-2.62).Conclusion sIAD≥10 mm Hg is an independent risk factor of carotid plaque in adults aged 40-<60 years.