高血压对皮马印第安人死亡率的影响
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
概括
高血压显著增加了皮马印第安人没有糖尿病的心血管疾病死亡率. 在糖尿病患者中,高血压强烈预测糖尿病病导致的死亡,而不是心血管疾病.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 研究了5284名皮马印第安人的高血压对死亡率的影响.
- 包括1698名2型糖尿病患者在基线或随访期间.
研究的目的:
- 调查高血压对皮马印第安人2型糖尿病和没有2型糖尿病的死亡率的差异影响.
- 了解高血压,心血管疾病和糖尿病病死亡率之间的关系.
主要方法:
- 前性队列研究,平均随访时间为12.2年.
- 利用比例危险模型来分析死亡原因.
- 根据多种风险因素进行调整,包括年龄,性别,BMI,胆固醇,葡萄糖和蛋白尿.
主要成果:
- 在非糖尿病患者中,高血压预测了心血管疾病死亡 (DRR=2.8).
- 在糖尿病患者中,高血压强烈预测了糖尿病病的死亡 (DRR=3.5),但不是心血管疾病 (DRR=1.4).
- 总死亡人数:非糖尿病患者470人,糖尿病患者488人.
结论:
- 高血压对心血管疾病死亡率的影响在糖尿病的皮马印第安人中较弱.
- 这归因于高血压对该人群糖尿病病进展的影响更大.
- 潜在的促成因素包括早期糖尿病发病,低吸烟率和有利的脂质状况.
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