基于China-PAR模型正常高值血压与心血管病风险相关性研究

The association between high-normal blood pressure and the risk of cardiovascular diseassee

目的 基于China-PAR(Prediction for ASCVD Risk in China)模型,探讨正常高值血压水平与未来10年动脉粥样硬化性心血管病(Atherosclerotic cardiovascular disease, ASCVD)风险的相关性。方法 收集2020年9月至2022年12月在广州市某三甲医院全科和广州市某社区医院就诊的694例患者的临床资料,对所有患者进行一般资料调查、体格检查和血液生化检查,使用China-PAR模型评估所有患者未来10年ASCVD发病风险。结果 正常血压、正常高值血压和高血压的检出人数分别为73例(10.52%)、197例(28.39%)和424例(61.09%);正常高值血压患者检出率基本呈现随年龄增高逐渐下降趋势;与正常血压组比较,正常高值血压和高血压组患者年龄、腰围、血压值、FBG、糖尿病患病率和心血管病家族史比例更高,差异有统计学意义(均P<0.05)。二元logistic回归分析显示年龄、腰围是正常高值血压发生的影响因素。未来10年ASCVD风险评估显示,高危人群比例随血压分级和年龄的增高而增高,男性高危人群比例比女性高。有序logistic回归分析显示,与正常血压患者相比,正常高值血压与未来10年ASCVD发病风险升高明显相关[95%CI=-1.441(-2.177~-0.704),P<0.001]。结论 基于China-PAR模型,正常高值血压与未来10年ASCVD发病风险升高明显相关。

Objective Based on the Prediction for Atherosclerotic cardiovascular disease(ASCVD)risk in China,to investigate the correlation between high-normal blood pressure and the Risk of ASCVD in 10 years.Methods A total of 694 patients from a general and a community hospital were enrolled in this study.The general information survey,physical examination and blood biochemical examination were conducted for all patients.The 10-year ASCVD risk of all patients was assessed using China-PAR model.Results 73(10.52%)of all the patients were normal blood pressure,197(28.39%)patients were normal high-blood pressure,and 424(61.09%)patients were hypertension.The detection rate of normal high-blood pressure patients showed a gradually decreasing trend with the increase of age.Compared with the normal blood pressure group,age,waist circumference,blood pressure,FBG,prevalence of diabete and family history of cardiovascular disease was higher in the high-normal blood pressure group and the hypertension group,with statistical significance(all P<0.05).Binary logistic regression analysis showed that age and waist circumference were the influencing factors of normal-high blood pressure.The 10-year ASCVD risk assessment showed that the proportion of high-risk population increased with the increase of blood pressure level and age,the proportion of high-risk groups in males is higher than that in females.Orderly Logistic regression analysis showed that compared with patients with normal blood pressure,high-normal blood pressure was significantly associated with increased risk of ASCVD in 10 years[95%CI=-1.441(-2.177~-0.704),P<0.001].ConclusionBIased on the China-PAR model,high-normal blood pressure is significantly associated with an increased risk of ASCVD in 10 years.