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収縮性血圧と死亡率について
1Department of Mathematics, University of California, Los Angeles 90025, USA. sport@ucla.edu
Lancet (London, England)
|February 16, 2000
まとめ
収縮性血圧のリスクは厳密に増加しているわけではない. 現在の高血圧ガイドラインは,年齢と性別に基づいて多くの成人のリスクを誤って分類する可能性があります.
科学分野:
- 心臓病学 心臓病学
- 公衆衛生は公衆衛生である.
- バイオ統計学 バイオ統計学
背景:
- 現在の高血圧ガイドラインでは,すべての成人の場合,シストリック血圧の値140mmHgを使用しています.
- WHOと国際高血圧学会からの推薦では,正常 (130 mm Hg) と最適 (120 mm Hg) の低血圧を示唆しています.
- これらのガイドラインは,シストリック血圧と死亡率の間の厳格な増加関係を想定しており,これは主にフレミングハム研究に基づいています.
研究 の 目的:
- フレミングハム研究データを再評価し,心血管疾患および全死亡リスクが収縮血圧に厳密に依存するか,または値が存在するかどうかを判断する.
- 静脈動脈血圧と死亡率に関する線形,増加するリスクモデルの仮定に異議を唱える.
主な方法:
- 統合血圧と死亡リスク (心血管疾患および全原因) の関係をモデル化するために,ロジスティックスプレインを使用した.
- 雇用年齢別および性別別率.
- 年齢と性別による傾斜パラメータの独立性をテストし,非従来のロジスティックモデルに共通する傾斜を伴う縮小モデルを使用した.
主要な成果:
- フレミングハムデータは従来の線形物流モデルを拒絶した.
- 全因性死亡率も心血管性死亡率も,シストリック血圧への厳格な依存度増加を示さなかった.
- リスクは,特定の年齢および性別依存の値 (70th percentile) 以下のシストリック血圧とは無関係であり,80th percentile以上では急激に増加しました.
結論:
- フレミングハムのデータは,シストリック血圧の低下は普遍的にリスクの低下を意味するという考えに反しています.
- 140mmHgの高血圧のカットオフ値は,年齢および性別によるリスクの値のため,普遍的に適用できるものではありません.
- 現在,増加したリスクと考えられている人口の有意な部分は,これらの発見に基づいてそうではないかもしれません.
関連する概念動画
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The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
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Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
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Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...

