摘要
目的 探讨在药物规则治疗下高血压病患者的脉压对冠心病发生的预测价值。方法回顾性分析 916例因胸痛而接受冠状动脉造影的高血压病患者的脉压与冠心病 (一支或以上冠状动脉管腔内径狭窄≥ 5 0 % )发生的相关性。结果 916例中 ,5 4 7例 (6 0 % )根据冠状动脉造影结果诊断为冠心病。冠心病组在年龄、高血压病程和其他冠心病危险因素 (吸烟、糖尿病 )暴露比例上显著高于无冠心病组。两组的各种血压参数也存在显著性差异。Logistic回归分析提示 ,脉压是冠心病发生的一个重要和独立危险因素 ,脉压每增加 5mmHg(1mmHg =0 133kPa) ,冠心病患病的危险性增加 2 9%(95 %可信区间 :2 2 % 37% ,P <0 0 0 0 1) ;在对年龄和其他冠心病危险因素 (吸烟、糖尿病、高脂血症 )校正后显示 ,脉压每增加 5mmHg ,冠心病患病的危险性增加 18% (95 %可信区间 :10 % 2 5 % ,P <0 0 0 0 1)。在多因素逐步回归模型中 ,脉压仍是冠心病发生的独立预测因素 ,Logistic多元回归方程如下 :P/ (1 P) =EXP[0 0 6 19×年龄 (岁 ) +0 0 334×脉压 (mmHg) +0 0 2 86×病程 (年 ) +0 6 84 2×吸烟+0 5 4 4 7×糖尿病 - 6 0 391]。其他血压参数则与冠心病发生无明显相关性。结论 在药物规则治疗的高血压病患者中 ,脉压是冠心病患?
Objective To determine whether pulse pressure (PP) is an independent and important predictor for the incidence of coronary artery disease (CAD) in essential hypertensive patients with anti hypertensive drug treatment Methods Parameters of blood pressure, clinical features and coronary angiographic findings were analyzed retrospectively in 916 patients with essential hypertension under standard antihypertensive treatment Results 547 (60%) patients had CAD (luminal diameter narrowing≥50%), and 369 (40%) patients had normal coronary arteries There was significant difference in age, duration of hypertension, incidence of other risk factors (smoking, diabetes) and parameters of blood pressure between patients with CAD and no CAD Logistic regression analysis showed that PP was strongly correlated with incidence of CAD in essential hypertensive patients After adjusting for sex and CAD risk factors, every 5 mm Hg increment in PP was associated with 18% increase in CAD risk (95% CI , 10% to 25%, P <0 000 1) In multivariate regression model, PP was still positively related with the incidence of CAD Other predictors were age, duration of hypertension and incidence of other risk factors (smoking, diabetes) The regression equation was as follow: P/(1 P)=EXP [0 061 9 *AGE(yrs)+0 033 4*PP(mm Hg)+0 028 6* duration of hypertension (yrs)+0 684 2*smoking+ 0 544 7 *diabetes 6 039 1] Conclusion PP may be an independent and important risk factor for CAD in patient with essential hypertension under standard antihypertensive treatment PP may be conductive to the risk stratification and antihypertension therapy
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2002年第6期325-327,共3页
Chinese Journal of Cardiology
