オーソスタティック低血圧は高齢者の死亡率を予測する:ホノルル・ハート・プログラム
K H Masaki1, I J Schatz, C M Burchfiel
1Honolulu Heart Program, Kuakini Medical Center, Honolulu, Hawaii, USA. kamal@hhp2.hawaii-health.com
Circulation
|November 24, 1998
まとめ
立身時の血圧の低下である正静性低血圧は,高齢の男性の死亡率を予測しています. この状態は,珍しいものの,高齢の ambulatory 個人の死亡のための重要な独立した危険因子です.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 心血管医学は,心臓血管医学である.
- エピデミオロジー エピデミオロジー
背景:
- 歩行高齢者,特にマイノリティー集団における死亡率に対する静止性低血圧の予測値に関する人口ベースのデータは限られている.
- 静止性低血圧は,立っているときに血圧が著しく低下すると定義されます.
研究 の 目的:
- 高齢の日本系アメリカ人男性における静止性低血圧と4年間の全原因死亡率との関連を調査する.
- オーソスタティック低血圧が,このコホートにおける死亡率の独立した予測因子であるかどうかを判断する.
主な方法:
- ホノルル・ハート・プログラムの第4回検査 (1991年から1993年) のデータを活用し,71歳から93歳までの日本系アメリカ人男性3522人を対象とした.
- 標準化された仰向けおよび立った状態の血圧測定を介して評価された正静性低血圧.
- 統計分析のためのコックス比例リスクモデルを使用し,多数の共変数に調整しました.
主要な成果:
- 矯正性低血圧の罹患率は6.9%で,年齢とともに増加しています.
- 静止性低血圧は,広範なコバリアート調整後でも,4年間の全原因死亡率 (RR 1.64,95%CI 1.19-2.26) の有意な独立した予測因子でした.
- シストリック血圧の低下と死亡率の大きさの間に有意な線形関連性および用量反応関係が観察されました.
結論:
- 静止性低血圧は,高齢の健診の男性における4年間の全原因死亡率の独立予測因子である.
- この状態は,高齢者の身体的弱さのマーカーとして機能する可能性があります.
- この発見は,高齢者の集団における正静性低血圧の評価の臨床的意義を強調しています.
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