在患有高血压的老年人中,脆弱性变化与死亡率的关联
Liying Li1, Linjia Duan2, Bingxue Wang3
1Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China.
Scientific reports
|April 11, 2025
概括
虚弱的变化显著影响老年高血压成年人的死亡率. 恶化的脆弱性增加了风险,而改善的脆弱性延长了生存时间,突出了脆弱性作为一个动态过程.
科学领域:
- 老年学是一门学科.
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 虚弱显著影响高血压患者的预后,但虚弱状态的变化不太了解.
- 之前的大多数研究都专注于基线脆弱性,忽视了其动态性质.
研究的目的:
- 在高血压的老年人中调查脆弱过渡和全因死亡率和心血管死亡之间的关联.
- 分析脆弱指数 (FI) 和死亡率的年度变化之间的剂量反应关系.
主要方法:
- 利用了来自中国长度健康长寿研究的1827名年龄较大的高血压参与者 (年龄≥65岁) 的数据.
- 在基线 (2011) 和随访 (2014) 时使用35项脆弱指数 (FI) 评估脆弱性,将参与者分为四个脆弱过渡组.
- 采用加速失效时间模型和限制立方线 (RCS) 来分析死亡风险和剂量反应关系.
主要成果:
- 与保持不脆弱相比,恶化的脆弱 (从不脆弱到脆弱,保持脆弱) 与所有原因死亡率和心血管死亡率的显著增加有关.
- 脆弱性的改善 (脆弱到非脆弱) 显示出死亡率下降的趋势,尽管对心血管死亡并不总是具有统计学意义.
- RCS分析显示,年度FI变化与所有原因和心血管死亡率之间存在非线性关系.
结论:
- 虚弱是老年高血压成年人的一个动态过程,对死亡率有重大影响.
- 虚弱状态的恶化加快了全因和心血管死亡率.
- 虚弱状态的改善与这一群体的延长生存时间有关.
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