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Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study.

血压类别与全因死亡率的性别特异性关联: 中国农村队列研究。

  • 影响因子:2.17
  • DOI:10.5888/pcd17.190131
  • 作者列表:"Liu L","Wang B","Liu X","Ren Y","Zhao Y","Liu D","Zhou J","Liu X","Zhang D","Chen X","Cheng C","Liu F","Zhou Q","Li J","Cao J","Chen J","Huang J","Zhang M","Hu D
  • 发表时间:2020-01-30
Abstract

INTRODUCTION:The relationship between blood pressure categories and all-cause mortality has not been fully addressed in cohort studies, especially in the general Chinese population. Our study aimed to assess the sex-specific association of systolic blood pressure (SBP), diastolic blood pressure (DBP), and 2017 United States hypertension guidelines with all-cause mortality in China. METHODS:We conducted a prospective study of 13,760 rural Chinese adults aged 18 or older (41.1% men). Mean age overall was 49.4, 51.0 for men, and 48.3 for women. We analyzed the blood pressure-mortality relationship by using restricted cubic splines and Cox proportional-hazards regression analysis, estimating hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS:During a mean follow-up of 5.95 years, 710 people died (60.3% men) from any cause. We found a U-shaped SBP-mortality or DBP-mortality relationship for both sexes. Mortality risk was increased for men with SBP 120-139 mm Hg (adjusted HR [aHR], 1.42; 95% CI, 1.10-1.82) or ≥140 mm Hg (aHR, 2.05; 95% CI, 1.54-2.72), and for DBP ≥90 mm Hg (aHR, 1.53; 95% CI, 1.10-2.13) as compared with SBP 100-119 mm Hg or DBP 70-79 mm Hg. Mortality risk also was increased for men with blood pressure status defined according to 2017 US hypertension guidelines as elevated, SBP 120-129 and DBP >80 mm Hg (aHR 1.48; 95% CI,1.11-1.98); stage 1 hypertension, SBP/DBP 130-139/80-89 mm Hg (aHR 1.53; CI, 1.19-1.97); and stage 2 hypertension, SBP/DBP ≥140/90 mm Hg (aHR 1.83; CI, 1.33-2.51). No significant relationship was observed for women. CONCLUSION:Elevated blood pressure and stages 1 and 2 hypertension were positively associated with all-cause mortality for men but not women in rural China.

摘要

引言: 血压类别与全因死亡率之间的关系在队列研究中尚未得到充分阐述,尤其是在一般中国人群中。我们的研究旨在评估收缩压 (SBP) 、舒张压 (DBP) 和 2017 美国高血压指南与中国全因死亡率的性别特异性关联。 方法: 我们对 13,760 名 18 岁或以上的中国农村成年人 (41.1% 名男性) 进行了一项前瞻性研究。总体平均年龄为 49.4 岁,男性为 51.0 岁,女性为 48.3 岁。我们通过使用限制三次样条和 Cox 比例风险回归分析,估计风险比 (HRs) 和 95% 置信区间 (CIs) 来分析血压-死亡率关系。 结果: 在平均 5.95 年的随访期间,有 710 人 (60.3% 名男性) 死于任何原因。我们发现两种性别的 U 形 SBP-死亡率或 DBP-死亡率关系。SBP 120-139毫米 Hg (校正 HR [aHR],1.42; 95% CI,1.10-1.82) 或 ≥ 140毫米 Hg (aHR,2.05; 95% CI, 1.54-2.72),DBP ≥ 90毫米 Hg (aHR,1.53; 95% CI,1.10-2.13)与 SBP 100-119毫米汞柱或 DBP 70-79毫米汞柱相比。根据 2017年美国高血压指南定义为血压状态升高、 SBP 120-129 和 DBP> 80毫米 Hg 的男性死亡风险也增加 (aHR 1.48; 95% CI, 1.11-1.98); 1 期高血压,SBP/DBP 130-139/80-89毫米 Hg (aHR 1.53; CI,1.19-1.97); 和 2 期高血压,SBP/DBP ≥ 140/90mm Hg (aHR 1.83; CI,1.33-2.51)。未观察到女性有显著关系。 结论: 血压升高和 1 、 2 期高血压与中国农村男性全因死亡率呈正相关,而与女性无关。

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