在 625 279 名患有高血压的老年参与者中，定期健康检查与降低死亡率的关系：一项基于人群的队列研究。

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-11-14 DOI:10.1016/j.puhe.2024.10.024

Zhengxin Li , Junru Wu , Qing Wen , Sangya Fu , Xuejing Sun , Tian He , Wen Zhang , Yao Lu , Hong Yuan , Jingjing Cai

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引用次数: 0

摘要

目的：健康体检是中国初级卫生保健政策的重要组成部分，也是对患有高血压和慢性病的老年人进行健康筛查和风险评估的关键措施。健康体检在降低心血管疾病和全因死亡率方面的作用仍存在争议。本研究旨在调查健康体检与患有高血压的老年人心血管疾病和全因死亡率之间的关系：研究设计：回顾性队列研究：这项研究纳入了625279名患有高血压的老年人。通过逆概率治疗加权（IPTW）匹配和 Cox 比例危险模型，检验了定期和不定期健康检查与心血管疾病相关（CVD 相关）死亡率、全因死亡率和非 CVD 相关死亡率的关系。对死亡率的调整后危险比（HRs）和 95 % 置信区间（CIs）进行了估计：共有 625 279 名参与者完成了健康评估。在 5.43 年的中位随访期间，共记录了 45,927 例心血管疾病相关死亡和 25,519 例非心血管疾病相关死亡。在 IPTW 之后，定期健康检查与心血管疾病相关死亡率和全因死亡率的降低显著相关（HR：0.442，95 % CI：0.434-0.450；HR：0.441，95 % CI：0.435-0.448）。在糖尿病患者中，定期健康检查与降低心血管疾病相关死亡率之间的关系更为密切（HR：0.40，95 % CI：0.39-0.42，P 为交互作用结论）：在患有高血压的老年人群中，尤其是在患有糖尿病、血脂异常和高血压高风险或极高风险的人群中，定期体检可能与心血管疾病死亡率和全因死亡率的降低有关。

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Association of regular health check-ups with a reduction in mortality in 625,279 elderly participants with hypertension: A population-based cohort study

Objectives

Health check-ups constitute an essential part of China's primary health care policy and a key measure for health screening and risk assessment for elderly people with hypertension and chronic diseases. The role of health check-ups in reducing the incidence of cardiovascular and all-cause mortality remains controversial. This study aimed to investigate the relationship between health check-ups and cardiovascular and all-cause mortality in elderly individuals with hypertension.

Study design

Retrospective cohort study.

Methods

This study included 625,279 elderly participants with hypertension. Associations of regular and irregular health check-ups with cardiovascular disease related (CVD-related) mortality, all-cause mortality and non-CVD-related mortality were tested via the inverse probability of treatment weighting (IPTW) matching and Cox proportional hazard models. Adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated for mortality.

Results

A total of 625,279 participants completed health assessments. During a median follow-up of 5.43 years, 45,927 CVD-related deaths and 25,519 non-CVD-related deaths were recorded. After IPTW, regular health check-ups were significantly associated with reduced CVD-related mortality and all-cause mortality (HR: 0.442, 95 % CI: 0.434–0.450; and HR: 0.441, 95 % CI: 0.435–0.448, respectively). An even stronger association between regular health check-ups and reduced CVD-related mortality was observed in participants with diabetes (HR: 0.40, 95 % CI: 0.39–0.42, P for interaction <0.001), dyslipidaemia (HR: 0.43, 95 % CI: 0.42–0.44, P for interaction <0.001) and a high risk or very high risk of hypertension (HR: 0.41, 95 % CI: 0.40–0.42, P for interaction <0.001).

Conclusions

Regular health check-ups may be associated with reductions in CVD mortality and all-cause mortality in the elderly population with hypertension, especially in individuals with diabetes, dyslipidaemia and a high risk or very high risk of hypertension.

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.