高血压人群LDL-C水平与脑卒中患病状况的关系研究

Relationship between LDL-C and Stroke Status in Hypertensive Population

目的了解我国≥35岁高血压人群低密度脂蛋白胆固醇(LDL-C)水平与脑卒中患病状况的关系。方法“十二五”国家科技支撑课题“中国重要心血管病患病率调查及关键技术研究”项目采用分层多阶段随机抽样的方法抽取调查对象。本研究选取该项目中15045例≥35岁高血压人群的基线资料进行分析,主要分析高血压人群LDL-C水平与脑卒中患病状况的关系。结果本研究中高血压人群脑卒中患病率为4.29%。调整其他所有变量后结果显示,参照组(LDL-C水平1.62~2.37 mmol/L)高血压人群脑卒中患病风险最低[LDL-C<1.62 mmol/L:OR=1.59,95%CI(1.09,2.32);LDL-C 2.38~2.84 mmol/L:OR=1.22,95%CI(0.96,1.57);LDL-C 2.85~3.35 mmol/L:OR=1.29,95%CI(1.01,1.64);LDL-C 3.36~4.35 mmol/L:OR=1.23,95%CI(0.96,1.57);LDL-C≥4.36 mmol/L:OR=1.32,95%CI(0.89,1.95)]。不同特征高血压人群调整其他所有变量后显示,男性、东部地区、不吸烟、不饮酒、无糖尿病、无心血管病家族史、舒张压<90 mmHg、血压已控制的高血压人群患脑卒中风险较高,且P均<0.05。亚组分析显示,与LDL-C 1.62~2.37 mmol/L相比,收缩压≥140 mmHg的高血压人群,无论LDL-C水平高与低,脑卒中的患病风险均高。结论LDL-C水平影响高血压人群脑卒中患病风险,应该合理调整高血压人群LDL-C水平。

Objective To investigate the influence of low-density lipoprotein cholesterol(LDL-C)level on the risk of stroke in hypertension population aged≥35 years in China.Methods The survey subjects were selected by stratified multi-stage random sampling supported by the national science and technology support project"The Prevalence of Important Cardiovascular Diseases and Key Technologies in China".A total of 15045 hypertensive people≥35 years old were selected in this study to analyze the impact of LDL-C level on the risk of stroke in hypertensive people.Results The prevalence of stroke in hypertensive population was 4.29%.After adjustment for all covariates,the risk of stroke was the lowest at LDL-C level 1.62-2.37 mmol/L compared with other data[LDL-C<1.62 mmol/L,OR=1.59,95%CI(1.09,2.32);LDL-C 2.38-2.84 mmol/L,OR=1.22,95%CI(0.96,1.57);LDL-C 2.85-3.35 mmol/L,OR=1.29,95%CI(1.01,1.64);LDL-C 3.36-4.35 mmol/L,OR=1.23,95%CI(0.96,1.57);LDL-C≥4.36 mmol/L,OR=1.32,95%CI(0.89,1.95)].After adjustment for all covariates,for male,eastern region,non-smoking,non-drinking,nondiabetic,non-family history of cardiovascular disease,diastolic blood pressure<90 mmHg,and blood pressure controlled,those with LDL-C level of 1.62-2.37 mmol/L showed the lowest risk of stroke than other LDL-C levels,and all with P<0.05.Subgroup analysis showed,compared with LDL-C levels of 1.62-2.37 mmol/L,those with systolic blood pressure≥140 mmHg was associated with an increased risk of stroke regardless of high or low LDL-C levels.Conclusion LDL-C level affects the risk of stroke in hypertensive population,and it should be adjusted reasonably in hypertensive population.