摘要
目的:探讨不同基线血压水平对40岁以下青年人群早发心脏病(发病年龄<55岁)的影响。方法:采用前瞻性队列研究方法,选取2006~2012年度首次参加开滦集团职工健康体检、40岁以下且血压资料完整、既往无心脏病病史者共35993例,以新发心脏病(包括冠心病、心房颤动及心力衰竭)为终点事件,随访至2021年年底。根据2018年中国高血压防治指南血压分级标准将受试者分为四组:正常血压组(n=13208)、血压正常高值组(n=16576)、高血压1级组(n=4357)、高血压2~3级组(n=1852)。采用Kaplan-Meier法计算不同基线血压水平分组的早发心脏病累积发病率,并采用log-rank检验进行组间比较。采用多因素Cox比例风险回归模型分析不同基线血压水平对早发心脏病的影响。结果:平均随访(12.5±2.6)年时,正常血压组、血压正常高值组、高血压1级组、高血压2~3级组的早发心脏病累积发病率分别为0.47%、0.97%、3.56%和4.42%(log-rank P<0.01)。Cox回归分析结果显示,校正年龄、性别等混杂因素后,与正常血压组相比,血压正常高值组、高血压1级组、高血压2~3级组早发心脏病HR(95%CI)分别为1.59(1.12~2.24)、2.08(1.41~3.08)和3.20(2.11~4.85),P均<0.01。结论:血压水平升高是青年人群早发心脏病的危险因素。
Objectives:To explore the association between different blood pressure levels at baseline and early-onset heart disease among young adults under 40 years in China.Methods:This prospective cohort study included 35993 subjects who participated in the physical examination of the employees of Kailuan Group for the first time from 2006 to 2012 and were younger than 40 years,with complete blood pressure data and had no history of heart disease.Participants were followed up to the end of 2021.The primary endpoint was early-onset heart disease(including coronary heart disease,atrial fibrillation,and heart failure).According to 2018 Chinese guidelines for the management of hypertension,the participants were divided into four groups:normal blood pressure group(n=13208),elevated blood pressure group(n=16576),stage 1 hypertension group(n=4357),and stage 2-3 hypertension group(n=1852).The cumulative incidence of heart disease among participants with different blood pressure levels at baseline was compared using log-rank test.Multivariate Cox proportional hazard regression model was used to analyze the impact of different blood pressure levels at baseline on early-onset heart disease in this cohort.Results:After a mean follow-up of(12.5±2.6)years,the cumulative incidence of early-onset heart disease in normal blood pressure group,elevated blood pressure group,stage 1 hypertension group,stage 2-3 hypertension group were 0.47%,0.97%,3.56%and 4.42%respectively(log-rank P<0.01).After adjusting for confounding factors such as age and sex,Cox regression analysis showed that the HR(95%CI)of heart disease in the elevated blood pressure group,hypertension grade 1 group and hypertension grade 2-3 group were 1.59(1.12-2.24),2.08(1.41-3.08)and 3.20(2.11-4.85)(all P<0.01),respectively,compared with the normal blood pressure group.Conclusions:Elevated blood pressure is a risk factor for early-onset heart disease among young Chinese population.
作者
李文娟
万勇超
郭路
许文奇
古平
陈朔华
吴寿岭
邢爱君
LI Wenjuan;WAN Yongchao;GUO Lu;XU Wenqi;GU Ping;CHEN Shuohua;WU Shouling;XING Aijun(Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China;School of Clinical Medicine,North China University of Science and Technology,Tangshan 063000,China;School of Public Health,North China University of Science and Technology,Tangshan 063210,China;Physical Examination Center,People's Liberation Army Navy 971 Hospital,Qingdao 266000,China)
出处
《中国循环杂志》
CSCD
北大核心
2023年第12期1267-1273,共7页
Chinese Circulation Journal
关键词
青年人群
血压水平
早发心脏病
队列研究
young population
blood pressure level
early-onset heart disease
cohort study
