收缩压和血糖处于目标范围的时间与心血管疾病和全因死亡风险的关系。

IF 4.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Hypertension Research Pub Date : 2024-10-30 DOI:10.1038/s41440-024-01969-0
Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Shuohua Chen, Yi Wang, Shouling Wu, Anxin Wang
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引用次数: 0

摘要

在现实世界中,有关收缩压(SBP)和空腹血糖(FBG)在目标范围内的时间(TTR)的综合影响的证据很少。我们旨在评估 SBP TTR 和 FBG TTR 对合并高血压和糖尿病的参与者中心血管疾病(CVD)和全因死亡率风险的单独和联合影响。数据来源于开滦研究。SBP和FBG的目标范围分别为110-140 mmHg和3.9-7.0 mmol/L,并通过线性内插法计算TTR。采用 Cox 比例危险回归模型估算 SBP TTR 和 FBG TTR 对心血管疾病和全因死亡风险的单独和合并影响。我们纳入了 11,899 名合并高血压和糖尿病的参与者,他们的平均年龄为(54.52 ± 10.36)岁,其中 9,873 人(83.00%)为男性。随访 6.67 年后,记录了 1,381 例心血管疾病和 2,148 例全因死亡病例。在完全调整模型中,与 SBP TTR 和 FBG TTR 均低于 25% 的参与者相比,SBP TTR 和 FBG TTR 均高于 25% 的参与者患心血管疾病(HR:0.53;95%CI:0.57-0.78)和死亡(HR:0.59;95%CI:0.47-0.74)的风险最低。SBP TTR 每增加 1 SD,心血管疾病风险降低 14%(HR:0.86;95% CI:0.80-0.92),死亡率风险降低 10%(HR:0.90;95% CI:0.85-0.95),所有显著结果在 FBG TTR 分析中均得以保持。在合并高血压和糖尿病的参与者中,较高的 SBP TTR 和 FBG TTR 均与较低的心血管疾病和全因死亡风险相关。同时将 SBP 和 FBG 控制在目标范围内是一种有益的心血管疾病预防策略。
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Time in target range for systolic blood pressure and glucose with cardiovascular disease and all-cause mortality risks.

Evidence on the combined effect of time in the target range (TTR) for systolic blood pressure (SBP) and fasting blood glucose (FBG) in real-world settings was scarce. We aimed to evaluate the separate and combined effects of SBP TTR and FBG TTR on cardiovascular disease (CVD) and all-cause mortality risks among participants with comorbidity of hypertension and diabetes. The data was derived from the Kailuan study. The target ranges for SBP and FBG were set as 110-140 mmHg and 3.9-7.0 mmol/L, and linear interpolation to calculate TTR. Cox proportional hazard regression models were used to estimate the separate and combined effects of SBP TTR and FBG TTR on CVD and all-cause mortality risks. We included 11,899 participants with hypertension and diabetes comorbidity whose mean age was 54.52 ± 10.36 years, and 9,873 (83.00%) were male. After a follow-up of 6.67 years, 1,381 cases of CVD and 2,148 cases of all-cause mortality were documented. In the fully adjusted model, compared with the participants with both SBP TTR and FBG TTR lower than 25%, participants with both greater SBP TTR and FBG TTR had the lowest risks of CVD (HR: 0.53; 95%CI: 0.57-0.78) and mortality (HR: 0.59; 95%CI: 0.47-0.74). Per 1 SD increase in SBP TTR was associated with a 14% reduction in CVD risk (HR, 0.86; 95% CI, 0.80-0.92) and a 10% reduction in mortality risk (HR, 0.90; 95% CI, 0.85-0.95), all significant results were maintained in the FBG TTR analyses. Both higher SBP TTR and FBG TTR were associated with lower risks of CVD and all-cause mortality in participants with comorbidity of hypertension and diabetes. Simultaneous control of SBP and FBG within the target ranges is a beneficial strategy for CVD prevention.

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来源期刊
Hypertension Research
Hypertension Research 医学-外周血管病
CiteScore
7.40
自引率
16.70%
发文量
249
审稿时长
3-8 weeks
期刊介绍: Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.
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