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目的分析非高血压人群中不同收缩压(SBP)水平对新发脑卒中的影响。方法采用前瞻性队列研究,提取开滦集团在职及离退休职工于2006年7月~2007年10月第一次健康体检,以及2008~2009年、2010~2011年、2012~2013年第二、三、四次健康体检的相关数据。以第一次健康体检为随访起点,以新发脑卒中为终点事件,随访结束时间为2013年12月31日。依据基线收缩压水平分为3组:A组(SBP<120 mmHg,25 239例)、B组(120 mmHg≤SBP<130 mmHg,19 087例)和C组(130≤SBP<140mmHg,10 433例)。结果共纳入54 759例,其中男性41 321例,女性13.438例,基线平均年龄为(48.48±12.53)岁。A组、B组和C组年龄、血压、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、体质指数(BMI)呈升高趋势,差异有统计学意义(P均<0.05)。平均随访6.97年,新发脑卒中825例,A组、B组、C组的发病率分别为1.06%、I.67%、2.29%,呈增高趋势,差异有统计学意义(P均<0.05)。A组、B组、C组男性的发病率分别为1.20%、1.85%、2.53%,呈增高趋势,差异有统计学意义(P均<0.05),女性为0.76%、0.94%、1.10%。多变量COX比例风险回归模型显示:校正了年龄、性别、BMI、总胆固醇(TC)、二三酰甘油(TG)、吸烟、饮酒、教育程度后,C组和B组发生脑卒中的风险分别是A组的1.26倍(95%CI:1.05~1.51)和1.24倍(95%CI:1.05~1.46,P均<0.05);男性中分别为1.41倍(95%CI:1.15~1.72)、1.33倍(95%CI:1.11~1.60,P均<0.05)。结论男性非高血压人群中,随收缩压水平的升高新发脑卒中的发生率升高,发病风险升高。
Objective To analyze the effect of different systolic blood pressure (SBP) levels on new stroke in non-hypertensive population. Methods A prospective cohort study was conducted to extract the first physical examination of serving and retired workers of Kailuan Group from July 2006 to October 2007 and the second, third and fifth consecutive health examinations in 2008 ~ 2009, 2010 ~ 2011, 2012 ~ 2013, Third, four times the health check-up data. Taking the first physical examination as the starting point of follow-up, new-onset stroke was the end point, and the follow-up was ended on December 31, 2013. Baseline systolic blood pressure was divided into three groups: group A (SBP <120 mmHg, 25 239), group B (120 mmHg≤SBP <130 mmHg, 19 087) and group C (130≤SBP <140 mmHg, 10 433 example). Results A total of 54 759 cases were enrolled, 41 321 males and 13.438 females, with an average baseline age of (48.48 ± 12.53) years. The age, blood pressure, HDL-C, FBG and BMI in group A, group B and group C showed an increasing tendency with statistical significance (all P <0.05) . The average follow-up of 697 years, the new stroke in 825 cases, the incidence of group A, B, C were 1.06%, I.67%, 2.29%, showed an upward trend, the difference was statistically significant (P <0.05 ). The incidence of males in group A, group B and group C was 1.20%, 1.85% and 2.53%, respectively, showing an increasing trend with a significant difference (P <0.05). The incidence of males was 0.76%, 0.94% and 1.10% respectively. Multivariable COX proportional hazards regression model showed that the risk of stroke in groups C and B were adjusted after adjusting for age, sex, BMI, total cholesterol (TC), triglyceride (TG), smoking, drinking and education Were 1.26 times (95% CI: 1.05-1.51) and 1.24 times (95% CI: 1.05-1.46, P <0.05 respectively) in group A, and 1.41 times (95% CI: 1.15-1.72) and 1.33 (95% CI: 1.11 ~ 1.60, P <0.05). Conclusions In male non-hypertensive population, the incidence of new-onset stroke increases with the increase of systolic blood pressure, and the risk increases.