脈圧と心血管疾患関連死亡率:多重リスク因子介入試験 (MRFIT) のフォローアップ研究
Michael Domanski1, Gary Mitchell, Marc Pfeffer
1Division of Biostatistics, School of Public Health, 2221 University Ave SE, Room 200, Minneapolis, MN 55414, USA.
JAMA
|May 22, 2002
まとめ
シストリックおよびダイアストリック血圧 (SBP/DBP) は,脈圧よりも心臓血管疾患の死亡率のより良い予測因子です. SBPとDBPを併用すると,男性におけるリスク評価が改善されます.
科学分野:
- 心臓病学 心臓病学
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- 合同国家委員会 (JNC-VI) の分類では,心血管疾患 (CVD) リスクに対してシストリック血圧 (SBP) とダイアストリック血圧 (DBP) を用いている. 脈圧も潜在的な危険因子と考えられています.
- SBP,DBP,およびパルス圧の独立したおよび結合された予測値を理解することは,正確なCVDリスク層分化に不可欠です.
研究 の 目的:
- SBP,DBP,および脈圧の関係,個別におよび共同で,男性におけるCVD関連死亡率と比較する.
- これらの血圧パラメータが,異なるJNC-VIカテゴリーおよび年齢層における死亡率とどのように関係しているかを評価する.
主な方法:
- 1973年から1975年の間にスクリーニングされた35歳から57歳の342,815人の男性を含む多重リスク因子介入試験 (MRFIT) のデータを利用した.
- SBPとDBPに基づくJNC-VIカテゴリーに従って参加者の血圧を分類し,脈圧を計算した.
- 1996年までCVD関連の死亡率を評価し,SBP,DBP,脈圧との関係を分析した.
主要な成果:
- 合計で25,721人のCVD関連の死亡が記録されました.
- SBPとDBPは,脈圧と比較して,CVD関連の死亡率とより強い関連性を示しました.
- SBPとDBPのコンコードントの上昇は,両方の年齢層で死亡リスクが増加しました; より高いSBPとより低いDBPは,より高齢の男性 (45-57歳) のリスクも上昇しました.
結論:
- SBPとDBPの両方を一緒に検討すると,SBP,DBP,または脈圧を単独で評価するよりも,心血管疾患のリスク評価が改善されます.
- この組み合わせのアプローチは,異なる年齢層の男性におけるリスクの階層化を高めます.
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