脑血管病危险因素干预对血压变化及脑卒中发病情况的影响

The effect of intervention on blood pressure and incidence of cerebrovascular diseases

目的 分析脑血管病危险因素干预对血压变化及脑卒中发病情况的影响。 方法 1987年在长沙市社区人群中选择两个社区作为干预和对照人群 ,检测血压并随访脑卒中发病情况。 结果 14年后 ,干预和对照两组队列人群的脑血管病的累计发病人数分别为 89例和 12 8例 ;两组人群血压均随年龄的增长而增加 ,但对照组增加明显 ;对脑卒中发病情况绘制K M线显示干预队列未发生脑卒中的比率明显高于对照组 (P =0 0 0 5 ) ;COX回归模型显示对照组脑卒中的发病危险是干预组的 1 4倍 ;基线收缩压处于 130～ 139mmHg水平和基线舒张压处于 80～ 84mmHg、85～ 89mmHg水平时只在对照组对脑卒中的发病存在危险性。 结论 长期脑血管病危险因素干预可以延缓血压随年龄增长而逐渐增高的现象、降低基线血压对脑卒中发病的危险及降低脑卒中的发病。

Objective To study the effect of intervention on blood pressure and incidence of cerebrovascular diseases. Methods In 1987, two cohorts population were selected in urban areas of Changsha . One was intervention group , another was control group. Baseline blood pressure levels were investigated and the events of stroke were collected. Results After 14 years, the cumulative stroke events were 89 in the intervention group and 128 in the control group; the mean blood pressure increased with statistical significance in each group except diastolic pressure in intervention group, but the control group increased more significantly; the analysis of Kaplan-Meier displayed that the rate of non-stroke events were higher in intervention group than that in control group and the analysis of COX regression indicated that the risk for stroke-events were 1.4 times higher in control group. Conclusions The intervention of risk factors can delay the increase of blood pressure by aging and reduce the risk of stroke-events.