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目的探讨正常高值收缩压与人群全因死亡的关系。方法采用前瞻性队列研究方法,以首次参加2006-2007、2008-2009年开滦集团健康体检的职工作为观察对象。进行统一问卷调查、体格测量和生化检查,以发生全因死亡为终点事件。根据《中国高血压防治指南2010》血压水平分类标准,将2006-2007年和2008-2009年第1次参加体检的人群按收缩压分为3组:<120mm Hg组(n=32 412)、120~<130mm Hg组(n=23 822)、130~<140mm Hg组(n=12 543),共68 777人。用寿命表法计算全人群、男性及女性人群的累积全因死亡率,并采用Cox比例风险模型分析正常高值收缩压对全人群、男性及女性人群全因死亡的影响。结果平均随访(7.39±1.14)年,全人群3组累积全因死亡率分别为2.85%、3.99%、6.19%;男性人群分别为3.72%、4.68%、6.83%;女性人群分别为0.90%、1.14%、2.88%。多因素Cox比例风险回归模型分析显示,校正全部混杂因素后,以收缩压<120mm Hg组为对照,全人群120~<130mm Hg和130~<140mm Hg组发生全因死亡风险比(95%CI)分别为1.13(1.01~1.28)和1.24(1.09~1.42);男性分别为1.16(1.02~1.31)和1.23(1.07~1.41);女性分别0.82(0.52~1.29)和1.47(0.92~2.35);青、中、老年120~<130mm Hg和130~<140mm Hg组发生全因死亡风险比(95%CI)分别为1.55(0.86~2.78)和1.64(0.77~3.49);1.24(1.04~1.48)和1.38(1.12~1.71);1.00(0.84~1.18)和1.10(0.93~1.30)。结论正常高值收缩压能够增加人群全因死亡的风险,男性人群和中年人群风险更为显著。
Objective To investigate the relationship between normal high systolic blood pressure and all-cause mortality in population. Methods A prospective cohort study was conducted to observe the workers who participated in the physical examination of Kailuan Group for the first time in 2006-2007 and 2008-2009. Uniform questionnaires, physical measurements and biochemical tests to cause all-cause death as the end point. According to the blood pressure level classification standard of “China Hypertension Prevention and Treatment Guideline 2010”, the groups participating in physical examination for the first time in 2006-2007 and 2008-2009 were divided into three groups according to systolic blood pressure: <120 mm Hg group (n = 32 412) A total of 68 777 people were enrolled in the Hg group (n = 23 822) and the 130 ~ <140 mm Hg group (n = 12 543) in the 120 to 130 mm Hg group. The Cox proportional hazards model was used to analyze the effect of normal high systolic blood pressure on all-cause mortality in the whole population, men and women, using the life table method to calculate the cumulative all-cause mortality rate of the whole population, male and female population. Results The average all-cause mortality rate in the whole population was 2.85%, 3.99% and 6.19% respectively in the mean follow-up (7.39 ± 1.14) years. The male population was 3.72%, 4.68% and 6.83% respectively. The female population was 0.90% 1.14%, 2.88%. Multivariate Cox proportional hazards regression model analysis showed that the risk of all-cause mortality was 95% CI (120% <130mm Hg) and 130 ~ <140mm Hg (95% CI ) Were 1.13 (1.01-1.28) and 1.24 (1.09-1.42), respectively; male was 1.16 (1.02-1.31) and 1.23 (1.07-1.41) respectively; female was 0.82 (0.52-1.29) and 1.47 Risk ratios of all-cause death (95% CI) were 1.55 (0.86 ~ 2.78) and 1.64 (0.77 ~ 3.49), 1.24 (1.04 ~ 1.48) in the 120 ~ 130mm Hg and 130 ~ And 1.38 (1.12-1.71); 1.00 (0.84-1.18) and 1.10 (0.93-1.30) respectively. Conclusion Normal high systolic blood pressure can increase the risk of all-cause death in the population, and the risk is more significant in the male and middle-aged population.