中老年病人血压参数与冠心病的关系

Components of Blood Pressure and Coronary Heart Disease in Middle Age and Old Patients

目的 探讨中、老年病人中各血压参数与冠心病 (CHD)的关系。方法 对行冠状动脉造影的病人记录血压、性别、糖尿病等危险因素分组进行Logistic回归、逐步回归分析 ,比较各OR值。结果 <60岁病人组 ,舒张压 (DBP)的OR值最大 ( 1 2 0 ;95 %CI:1 14～ 1 2 8) ,DBP每增加 5mmHg ,CHD发病率增加率增加 2 0 %。 >60岁病人组 ,脉压 (PP)的OR值最大 ( 1 11;95 %CI :1 0 7～ 1 14 ) ,PP每增加 5mmHg ,冠心病发病率增加率增加 11%。逐步回归分析表明 ,DBP和PP分别是 <60岁病人组和 >60岁病人组CHD发病的重要影响因子。结论 中青年病人中 ,DBP高者CHD发病率较高 ,老年病人中 。

Objective To explore the association of various components of blood pressure with the incidence of coronary heart disease (CHD)in middle age and old patients. Methods Three hundred fifty-four patients diagnosed by coronary angiography were analyzed by parameters of blood pressure, sex, diabetes and other risk factors. Logistic regression and stepwise regression were used. Results After adjusting for other risk factors, logistic regression analyze showed that in the group <60 years of age, diastolic blood pressure(DBP) yielded the largest OR level ( 1.20;95% CI, 1.14-1.28 ). A 5 mmHg increase in DBP was associated with a statistically significant 20% increase in risk of CHD. In the group >60 years of age, PP yielded the greatest OR level (1.11; 95% CI, 1.07-1.14). A 5 mmHg increase in PP was associated with a statistically significant 11% increase in risk of CHD. Multivariate stepwise regression showed, DBP was positively related with the incidence of CHD in the group <60, and PP in the group>60. Conclusion In the middle aged patients, DBP level was strongly associated to the morbidity of CHD, while greater PP is in related to greater morbidity of CHD in the elder aged patients.