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背景在确诊心血管疾病风险大幅增加的队列研究人群中,臂间血压差越高,心血管疾病病死率越高。目的探讨在无心血管疾病病史的社区队列研究中,臂间血压差(IAD)与病死率的关系。设计与场所1998年4月—2008年10月,在苏格兰中部进行队列研究。方法从兰开夏郡、格拉斯哥和爱丁堡地区分别纳入无血管疾病史、臂-踝指数≤0.95的志愿者,招募时测量其双臂收缩压。计算志愿者IAD,探讨横截面关联和预期存活率差异。结局指标为8.2年随访期间的心血管事件和全因死亡率。结果基于单对血压测量结果显示3 350例志愿者中,60%的志愿者收缩压IAD≥5 mm Hg(1 mm Hg=0.133 k Pa),38%的志愿者收缩压IAD≥10 mm Hg。IAD≥5 mm Hg的志愿者心血管疾病病死率〔校正危险比为1.91,95%CI(1.19,3.07)〕和全因死亡率〔校正危险比为1.44,95%CI(1.15,1.79)〕较高。在764例高血压患者(亚组)中,IAD≥5 mm Hg或IAD≥10 mm Hg与心血管疾病病死率〔校正危险比分别为2.63、2.96,95%CI分别为(0.97,7.02)、(1.27,6.88)〕和全因死亡率〔校正危险比分别为1.67、1.63,95%CI分别为(1.05,2.66)和(1.06,2.50)〕相关,而IAD≥15 mm Hg与生存结局差异无关。结论在无心血管疾病病史的人群中,IAD越高,心血管事件发生风险越大,病死率越高。
Background In a cohort of cohorts diagnosed with a significant increase in the risk of cardiovascular disease, the higher the inter-arm BP, the higher the CFR. Objective To explore the relationship between inter-arm blood pressure (IAD) and mortality in a community-based cohort study without a history of cardiovascular disease. Design and Locations April 1998 - October 2008 Study in a cohort in central Scotland. Methods A volunteer with a history of no vascular disease and an arm-to-ankle index ≤0.95 was recruited from Lancashire, Glasgow and Edinburgh, respectively. Systolic blood pressure was measured at recruitment. Volunteer IAD was calculated to explore cross-sectional associations and expected survival differences. Outcome measures were cardiovascular events and all-cause mortality at 8.2 years of follow-up. Results Based on a single pair of blood pressure measurements, 60% of 3 350 volunteers had systolic blood pressure IAD ≥ 5 mm Hg (1 mm Hg = 0.133 kPa) and 38% of volunteers with IAD ≥ 10 mm Hg. Cardiovascular mortality (adjusted for hazard ratio 1.91, 95% CI 1.19, 3.07) and all-cause mortality (adjusted for hazard ratio 1.44, 95% CI 1.15, 1.79) in volunteers with IAD> 5 mm Hg Higher. Among 764 hypertensive patients (subgroups), the IAD ≥ 5 mm Hg or IAD ≥ 10 mm Hg and cardiovascular mortality (adjusted hazard ratios were 2.63, 2.96, 95% CI, 0.97, and 7.02, (1.27,6.88)] and all-cause mortality (adjusted for hazard ratio 1.67, 1.63, 95% CI, respectively 1.05, 2.66, and 1.06, 2.50) Nothing to do Conclusions In people without a history of cardiovascular disease, the higher the IAD, the greater the risk of cardiovascular events and the higher the case fatality rate.