摘要
目的探讨中国老年人随诊间收缩压变异性(systolic blood pressure variability,SBPV)和全因死亡风险的关系。方法基于2008―2018年中国纵向健康长寿调查(Chinese longitudinal healthy longevity survey,CLHLS)的跟踪数据集,选取≥65岁、有连续3次收缩压(systolic blood pressure,SBP)记录且随访至2018年的老年人作为研究对象。采用Cox比例风险回归模型分析老年人随诊间SBPV与全因死亡风险的关系;按性别、年龄亚组分析以评估随诊间SBPV的交互作用;最后,在模型中加入限制性立方样条(restricted cubic spline,RCS)探究两者的剂量-反应关系。结果(1)共纳入2582名老年人,平均年龄为78(71,86)岁,其中男性1253人(48.5%)。在平均3.29年的随访期间,共有739例(28.6%)老年人死亡;(2)校正相关混杂因素后,随诊间SBPV与全因死亡风险之间呈正相关,差异有统计学意义(P<0.05);(3)亚组分析显示:性别、年龄对不同随诊间SBPV水平与全因死亡风险的关联未发现效应修饰作用(P交互作用≥0.100);(4)RCS结果显示,随诊间SBPV与全因死亡风险之间的剂量-反应关系在男性和女性中一致,全因死亡风险随随诊间SBPV增大而线性升高(P总趋势SBPV<0.001,P非线性SBPV>0.05)。在不同年龄分组中,<70岁组的随诊间SBPV与全因死亡风险呈正线性关系,而其余年龄组两者均无剂量-反应关系(年龄<70岁组:P总趋势SBPV<0.001,P非线性SBPV>0.05;其余年龄组:P总趋势SBPV>0.05,P非线性SBPV>0.05)。结论中国老年人随诊间SBPV与全因死亡风险相关,其独立于随访期间平均SBP。除了检测老年人群的SBP外,还应关注其就诊以来SBP的波动情况。
Objective To investigate the relationship between follow-up systolic blood pressure variability(SBPV)and the risk of all-cause mortality in older adults across China.Methods Based on the follow-up dataset of the 2008-2018 China longitudinal healthy longevity survey(CLHLS),older adults aged 65 years or older with three consecutive times of recorded systolic blood pressure(SBP)and followed up until 2018 were selected as study subjects.A Cox regression analysis model was used to analyze the relationship between follow-up SBPV and all-cause mortality in older adults;analyses were conducted by gender and age subgroups to assess the interaction of follow-up SBPV;and finally,restricted cubic spline(RCS)was added to the model to explore the dose-response relationship between the two.Results(1)A total of 2582 older adults were enrolled,including 1253(48.5%)males with a median age of 78(71,86)years.A total of 739(28.6%)older adults died during a mean follow-up period of 3.29 years.(2)After correcting for relevant confounders,there was a significant positive association between follow-up SBPV and the risk of all-cause mortality(P<0.05).(3)Subgroup analyses showed no effect modification of gender and age on the association between different follow-up SBPV levels and the risk of all-cause mortality(Pinteraction≥0.100).(4)Restricted cubic spline results showed that the dose-response relationship between follow-up SBPV and the risk of all-cause mortality was consistent in both gender,with the risk of all-cause mortality increasing linearly with increasing follow-up SBPV.(Poverall SBPV<0.001,Pnon-linearity SBPV>0.05).Among the different age subgroups,follow-up SBPV was positively and linearly associated with the risk of all-cause mortality among those aged<70 years,while there was no dose-response relationship between the two in the remaining age subgroups(<70 years old:Poverall SBPV<0.001,Pnon-linearity SBPV>0.05;remaining age groups:Poverall SBPV>0.05,Pnon-linearity SBPV>0.05).Conclusions Follow-up SBPV was significantly ass
作者
徐家豪
吴俊
尹明娟
廖绍兵
吴亮
景文苑
唐鑫明
倪进东
XU Jiahao;WU Jun;YIN Mingjuan;LIAO Shaobing;WU Liang;JING Wenyuan;TANG Xinming;NI Jindong(Department of Epidemiology and Health Statistics,School of Public Health,Guangdong Medical University,Dongguan 523808,China;Shunde Women and Children′s Hospital of Guangdong Medical University(Maternal and Child Health Hospital of Shunde District,Foshan City),Foshan 528300,China;Precision Laboratory,School of Public Health,Guangdong Medical University,Dongguan 523808,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2024年第7期745-752,758,共9页
Chinese Journal of Disease Control & Prevention
基金
国家自然科学基金(82273709)
广东省自然科学基金(2021A1515011038)
广东医科大学学科建设项目(4SG23001G)
湛江市科技专项(2023B01047)。
关键词
收缩压变异性
全因死亡风险
剂量-反应关系
Systolic blood pressure variability
Risk of all-cause mortality
Dose-response relationship
