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目的探讨中老年正常高值血压人群血压水平与冠状动脉性心脏病(冠心病)的相关性。方法选取316例50岁以上接受冠状动脉造影检查的正常高值血压者,按照冠状动脉造影结果分为冠心病组(n=129)和非冠心病组(n=187)。对所有对象进行血压、身高、体质量测量,检测血脂指标。结果冠心病组舒张压低于非冠心病组[(73.1±8.9)比(77.0±8.0)mmHg],脉压高于非冠心病组[(55.9±10.5)比(51.2±9.5)mmHg]。对性别、年龄等常见冠心病危险因素调整后,较高的收缩压(≥130mmHg)、较低的舒张压(≤85mmHg)以及较大的脉压(≥60mmHg)与冠心病的发生相关,OR(95%CI)分别为1.60(1.04～2.46)、1.52(1.07～2.16)、1.90(1.06～3.39),均P<0.05。多因素Logistic逐步回归分析发现脉压≥60mmHg是冠心病的独立危险因素。结论在中老年正常高值血压人群中,较高的收缩压、较低的舒张压以及脉压增大与冠心病发生风险相关联,脉压≥60mmHg是冠心病的独立危险因素。
Objective To investigate the relationship between blood pressure and coronary heart disease (CHD) in middle-aged and elderly people with normal high blood pressure. Methods A total of 316 patients with normal high blood pressure over 50 years of age undergoing coronary angiography were divided into coronary heart disease group (n = 129) and non-coronary heart disease group (n = 187) according to coronary angiography results. All subjects for blood pressure, height, body mass measurement, detection of lipid indicators. Results The diastolic blood pressure in coronary heart disease group was significantly lower than that in non-coronary heart disease group (73.1 ± 8.9 vs 77.0 ± 8.0 mmHg), and the pulse pressure was higher than that in non-coronary heart disease group (55.9 ± 10.5 vs. 51.2 ± 9.5 mmHg). Coronary heart disease risk factors such as gender, age adjustment, higher systolic blood pressure (≥ 130mmHg), lower diastolic blood pressure (≤ 85mmHg) and greater pulse pressure (≥ 60mmHg) associated with the occurrence of coronary heart disease, OR (95% CI) were 1.60 (1.04 ~ 2.46), 1.52 (1.07 ~ 2.16), 1.90 (1.06 ~ 3.39), all P <0.05. Multi-factor Logistic regression analysis found that pulse pressure ≥ 60mmHg is an independent risk factor for coronary heart disease. Conclusion High systolic blood pressure, low diastolic blood pressure and increased pulse pressure are associated with the risk of coronary heart disease in elderly people with normal high blood pressure. Pulse pressure≥60mmHg is an independent risk factor for coronary heart disease.