ピマ・インディアンの死亡率に対する高血圧の影響
M L Sievers1, P H Bennett, J Roumain
1Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Circulation
|July 7, 1999
まとめ
高血圧は,糖尿病のないピマ・インディアンの心血管疾患による死亡率を大幅に増加させる. 糖尿病患者の場合,高血圧は心臓血管疾患ではなく,糖尿病性腎不全による死を強く予測します.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- エピデミオロジー エピデミオロジー
背景:
- 5284人のピマ・インディアンの死亡率に対する高血圧の影響を調べた.
- ベースラインまたはフォローアップ中の2型糖尿病患者1698人を含む.
研究 の 目的:
- 2型糖尿病と2型糖尿病のないピマ・インディアンの死亡率に対する高血圧の差異的な影響を調査する.
- 高血圧,心血管疾患,糖尿病性腎不全の死亡率との関係を理解する.
主な方法:
- 予見的なコホート研究で,追跡期間の中央値は12.2年.
- 死亡原因を分析するために,比例リスクモデルを使用した.
- 年齢,性別,BMI,コレステロール,グルコース,タンパク質尿を含む複数の危険因子に調整されています.
主要な成果:
- 高血圧は,非糖尿病患者の心血管疾患による死亡を予測した (DRR=2.8).
- 糖尿病患者の場合,高血圧は糖尿病性腎不全 (DRR=3.5) による死亡を強く予測したが,心血管疾患 (DRR=1.4) は予測できなかった.
- 死者総数:非糖尿病患者で470人,糖尿病患者で488人.
結論:
- 心血管疾患による死亡率に対する高血圧の影響は,糖尿病のピマ・インディアンではより弱い.
- これは,この集団における糖尿病性腎不全の進行に対する高血圧のより大きな影響によるものである.
- 潜在的要因には,糖尿病の早期発症,低喫煙率,好ましい脂質プロフィールなどがある.
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