摘要
目的探讨老年冠心病(CHD)合并高血压患者收缩压(SBP)下降过程中的J形曲线及SBP水平与主要不良心脑血管事件(MACCE)发生的关系。方法选取2010年3月~2012年3月于铜川矿务局中心医院心内科收治的323例老年CHD合并高血压患者,按照SBP水平分为5组:1组55例,SBP<120mm Hg;2组64例,SBP 120~129 mm Hg;3组79例,SBP 130~139 mm Hg;4组67例,SBP 140~149 mm Hg;5组58例,SBP≥150 mm Hg(1 mm Hg=0.133k Pa);比较5组的MACCE发生情况,建立Cox回归分析模型,并绘制曲线图进行趋势分析。结果随访期间共发现198起MACCE;Cox回归分析表明,在校正了年龄、体质指数(BMI)及SBP之后,发现SBP在140 mm Hg以上时,MACCE发生率明显较高;SBP控制在120~130 mm Hg时,发生MACCE的风险最小;而当SBP<120 mm Hg时,MACCE发生率反而有所升高。结论CHD合并高血压老年患者在降压过程中存在J形曲线现象,应合理控制血压以降低MACCE的发生。
Objective To investigate the relationship among J-curve,systolic blood pressure level duringsystolic blood pressure decreasing and major adverse cardiovascular and cerebrovascular events(MACCE)inpatients with senile coronary heart disease(CHD)complicating by hypertensive.Methods The patients withCHD complicating by hypertensive(n=323)were chosen from the Department of Cardiology of Central Hospital ofTongchuan Mining Bureau from Mar.2010to Mar.2012.The patients were divided,according to SBP level,into5groups:group1(n=55,SBP<120mmHg,group2(n=64,SBP120mmHg^129mmHg),group3(n=79,SBP130mmHg^139mmHg),group4(n=67,SBP140mmHg^149mmHg)and group5(n=58,SBP≥150mmHg).Theincidence of MACCE was compared among5groups.A Cox regression model was established and curve graphwas drawn for tendency analysis.Results There were198patients with MACCE during follow-up period.TheCox regression analysis showed that the incidence of MACCE increased significantly when SBP was higher than140mmHg after regulating age,body mass index(BMI)and SBP.When SBP was controlled from120mmHg to130mmHg,the risk of MACCE was the lowest,and when SBP<120mmHg,the incidence of MACCE,however,increased slightly.Conclusion J-curve phenomenon exists during hypotension process in elderly patients withCHD complicated by hypertension,so blood pressure should be reasonably controlled for reducing the incidence ofMACCE.
作者
马斐
杨会萍
任骞
MA Fei;YANG Hui-ping;REN Qian(Department of Cardiology, Central Hospital of Tongchuan Mining Bureau,Tongchuan City, Shaanxi Province, Tongchuan 727000, China)
出处
《中国循证心血管医学杂志》
2017年第2期225-227,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
冠心病
高血压
收缩压
心脑血管事件
J形曲线
Coronary heart disease
Hypertensive
Systolic blood pressure
Cardiovascular and cerebrovascular events
J-curve
