正静性低血压预测老年男性的死亡率:霍诺卢卢心脏计划
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
概括
正静性低血压,即站立时血压下降,预测了老年男性的死亡率. 这种情况虽然不常见,但是在老年门诊患者中,是死亡的重要独立风险因素.
科学领域:
- 老年学是指老年学的学科.
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 有限的基于人群的数据存在于静止性低血压的预测价值在门诊老年人的死亡率,特别是少数群体.
- 静止性低血压被定义为站立时血压显著下降.
研究的目的:
- 调查日本裔美国老年男性 ортостатической低血压和4年全因死亡率之间的关联.
- 要确定静止性低血压是否是这个队列中死亡率的独立预测因素.
主要方法:
- 利用了霍诺卢卢心脏计划第四次检查 (1991-1993) 的数据,包括3522名71-93岁的日裔美国男性.
- 通过标准化卧卧和站立血压测量来评估正静性低血压.
- 采用了考克斯的比例危险模型进行统计分析,并对许多共同变量进行调整.
主要成果:
- 静止性低血压的患病率为6.9%,随年龄增长而增加.
- 正静性低血压是四年全因死亡率 (RR 1.64,95% CI 1.19-2.26) 的重要独立预测因子,即使经过广泛的协变性调整.
- 在缩血压下降幅度和死亡率之间观察到显著的线性关联和剂量反应关系.
结论:
- 静止性低血压是老年门诊男性4年全因死亡率的独立预测因素.
- 这种情况可能成为老年人身体虚弱的标志物.
- 这些发现突显了评估老年人群中静止性低血压的临床意义.
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