Marte Meyer Walle-Hansen, Guri Hagberg, Marius Myrstad, Trygve Berge, Thea Vigen, Hege Ihle-Hansen, Bente Thommessen, Inger Ariansen, Magnus Nakrem Lyngbakken, Helge Røsjø, Ole Morten Rønning, Arnljot Tveit, Håkon Ihle-Hansen
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We categorised participants by systolic blood pressure (SBP) at age 40 (<120 mm Hg (reference), 120-129 mm Hg, 130-139 mm Hg and ≥140 mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes.</p><p><strong>Results: </strong>The mean age was 40.1±0.3 years (50.4% women) and mean SBP was 128.3±13.5 mm Hg (mean±SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4±2.9 years of follow-up. SBP between 130 and 139 mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP ≥140 mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95% CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions.</p><p><strong>Conclusions: </strong>SBP ≥140 mm Hg was significantly associated with 30-year stroke risk in both sexes. 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引用次数: 0
摘要
背景：美国和欧洲的指南对高血压的定义不同，且与性别无关。我们的目的是评估 40 岁时不同的高血压阈值对 30 年中风风险的影响，并研究性别差异：我们纳入了阿克苏斯1950年心脏检查研究（Akershus Cardiac Examination 1950 Study）中的2608名无中风患者，该研究是挪威于2012-2015年对1950年出生队列进行的一项地区性研究，这些患者曾参加过1990-1993年进行的全国性健康检查研究 "40岁计划"（Age 40 Program）。我们根据参与者在40岁时的收缩压（SBP）对其进行了分类（结果：平均年龄为40.1（±）岁，平均年龄为40.2（±）岁）：平均年龄为 40.1±0.3 岁（50.4% 为女性），平均收缩压为 128.3±13.5 mm Hg（平均值±SD）。在 29.4±2.9 年的随访期间，115 人（4.4%）发生了中风（女性 32 人（28%），男性 83 人（72%））。SBP 130 至 139 mm Hg 之间与脑卒中无关（调整 HR 1.71，95% CI 0.87 至 3.36），而 SBP ≥ 140 mm Hg 与脑卒中风险增加有关（调整 HR 3.11，95% CI 1.62 至 6.00）。女性中风的调整后 HR 为 4.32（95% CI 1.66 至 11.26），男性为 2.66（95% CI 1.03 至 6.89），性别间的交互作用不显著：结论：SBP ≥140 mm Hg 与男女 30 年卒中风险均有显著相关性。一小部分女性的收缩压≥140 mm Hg，收缩期高血压是这些女性中风的一个重要风险因素：试验注册号：NCT01555411。
Systolic blood pressure at age 40 and 30-year stroke risk in men and women.
Background: American and European guidelines define hypertension differently and are sex agnostic. Our aim was to assess the impact of different hypertension thresholds at the age of 40 on 30-year stroke risk and to examine sex differences.
Methods: We included 2608 stroke-free individuals from the Akershus Cardiac Examination 1950 Study, a Norwegian regional study conducted in 2012-2015 of the 1950 birth cohort, who had previously participated in the Age 40 Program, a nationwide health examination study conducted in 1990-1993. We categorised participants by systolic blood pressure (SBP) at age 40 (<120 mm Hg (reference), 120-129 mm Hg, 130-139 mm Hg and ≥140 mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes.
Results: The mean age was 40.1±0.3 years (50.4% women) and mean SBP was 128.3±13.5 mm Hg (mean±SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4±2.9 years of follow-up. SBP between 130 and 139 mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP ≥140 mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95% CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions.
Conclusions: SBP ≥140 mm Hg was significantly associated with 30-year stroke risk in both sexes. A small subgroup of women had SBP ≥140 mm Hg and systolic hypertension was a strong risk factor for stroke in these women.
期刊介绍：
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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