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目的 探讨脉压在我国人群中的分布特征及与主要心血管疾病的关系。方法 对1991年全国第三次高血压抽样调查中年龄≥ 18岁的 882 6 81人的资料进行再分析。统计分析采用t检验、χ2 检验 ,多因素分析使用logistic回归模型。结果 (1)人群的脉压均值为 (44 6 1± 13 5 9)mmHg(1mmHg =0 133kPa) ,其中男性为 (44 92± 12 72 )mmHg,女性为 (44 34± 14 32 )mmHg。随年龄的增长脉压逐渐增宽 ,5 0岁以后脉压增宽的幅度加速且女性高于男性。在≥ 6 0岁人群中 ,脉压≥ 6 0mmHg的比例高于 <6 0岁组人群。 (2 )随脉压增宽 ,脑卒中和心肌梗死的患病率也呈增加趋势。 (3)多因素logistic回归模型分析显示 ,调整了性别、年龄、体重指数、吸烟及饮酒后 ,以脉压 <4 5mmHg的人群为基线组 ,脉压为 4 5～ 5 9、6 0～ 74和≥ 75mmHg组人群 ,脑卒中的患病危险分别是基线组的 1 9、3 5和 5倍。同样 ,心肌梗死的患病危险是基线组的 1 2、1 5和 1 7倍。将收缩压和舒张压纳入影响因素中再分析 ,仍显示脑卒中和心肌梗死的患病危险随脉压的增宽而增加。结论脑卒中和心肌梗死的患病率随脉压的增宽而增高 ,脉压增宽是脑卒中和心肌梗死患病的危险因素之一 ,尤其在老年人群中更为明显。
Objective To investigate the distribution of pulse pressure in Chinese population and its relationship with major cardiovascular diseases. Methods The data of 882 6 81 persons aged 18 years or older in the third national high blood pressure sampling survey in 1991 were reanalyzed. Statistical analysis using t test, χ2 test, multivariate analysis using logistic regression model. Results (1) The average pulse pressure of the population was (44 6 1 ± 13 5 9) mmHg (1 mmHg = 0 133 kPa), of which 44 92 ± 12 72 mmHg for men and 44 34 ± 14 32 mmHg for women. Pulse pressure gradually widened with age, and the rate of pulse pressure widened after the age of 50 was higher in women than in men. Among ≥60 years of age, the rate of pulse pressure ≥60 mmHg was higher than that of patients younger than 60 years. (2) With the widening pulse pressure, the prevalence of stroke and myocardial infarction also showed an increasing trend. (3) Multivariate logistic regression analysis showed that the adjusted baseline of gender, age, body mass index, smoking and drinking were based on the group of pulse pressure <4 5 mmHg and the pulse pressure was 45-59, 60-74 And ≥75 mmHg group, the risk of stroke was 19.3, 5 and 5 times higher than those in the baseline group, respectively. Similarly, the risk of MI was 12, 15, and 17 times the baseline. The inclusion of systolic and diastolic blood pressure in the reanalysis of influencing factors still shows that the risk of stroke and myocardial infarction increases with increased pulse pressure. Conclusions The prevalence of stroke and myocardial infarction increases with the increase of pulse pressure. Widening pulse pressure is one of the risk factors of stroke and myocardial infarction, especially in the elderly.