脉压与心脑血管病的关系:一个大样本的随访研究

目的 研究脉压(PP)是否与死亡有关,尤其是否与心、脑血管病有关.方法选择了1992-1993年,在韩国医疗保险公司投保年龄在40岁及以上的投保人,共有698 796人,随访7年.随访开始时对每个观察对象进行健康检查并调查相关问题,随访期每2年进行1次查体.结果 PP与全因死亡、心、脑血管病死亡有正相关关系.无论性别、年龄以及是否患有高血压,均得到相同结果,即随着PP升高,死亡危险性升高.但年龄越大,脉压的影响力度越弱.结论 PP与全因死亡率、心脑血管病死亡率呈相关关系,在预测心脑血管病危险性时,PP可以作为一个独立的预测指标.     

肌钙蛋白T对腹膜透析患者预后的预测作用

目的探讨腹膜透析患者血清心肌肌钙蛋白T(cTnT)对其心脑血管疾病及死亡的预测价值。方法选择衡阳市第一人民医院行规律腹膜透析患者214例,检测透析前后生化及心脏形态改变。随访3 a或至其死亡,记录随访期间患者死亡及发生心脑血管事件情况。结果 cTnT与糖尿病、心脑血管病史、hs-CRP、左心室重量指数(LVMI)呈正相关,与eGFR、左室射血分数呈负相关。生存分析显示cTnT≥0.1μg/L组初发心脑血管事件、心脑血管事件死亡率及全因死亡率明显升高;COX比例风险回归模型分析示cTnT可预测初发心脑血管事件、心脑血管事件死亡率及全因死亡率,并独立于hs-CRP、eGFR、LVMI、左室射血分数、透析时间因素之外。结论 cTnT为腹膜透析患者初发心脑血管事件、心脑血管病死亡事件及全因死亡事件的独立预测因子。     

血压的各种指标对中老年人心脑血管病死亡事件的预测价值

目的探讨中、老年人收缩压(SBP)、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)水平对远期心脑血管死亡事件预测价值的差异。方法对中老年人群10786例进行基线调查,随访8年,应用Cox回归分析4个血压指标对远期心脑血管死亡事件预测价值的差异。结果校正其他因素后,MAP和SBP分别为中、老年人最强烈的预测远期心脑血管病死亡事件危险程度的血压指标。中老年人4个血压指标每升高1个标准差(SD),其发生心脑血管病死亡危险的相对危险度(RR)由高到低分别为:(1)中年组:MAP(1.837),SBP(1.782),DBP(1.775),PP(1.750);(2)老年组:SBP(1.345),MAP(1.343),DBP(1.219),PP(1.215)。结论4个血压指标对心脑血管死亡事件的预测在不同的年龄段是不同的。中年人应着重于总体血压的控制,老年人应首先控制SBP。     

吲哒帕胺缓释片与左旋氨氯地平片对老年单纯收缩期高血压的疗效和安全性比较

大量研究证实,收缩压(SBP)及脉压(PP)的升高与心脑血管病之间存在独立而极其显著的相关性[1],是脑血管病和冠心病危险性的重要预测因子.积极降低单纯收缩期高血压(ISH)患者收缩压与脉压水平可显著降低心脑血管发病率及病死率.     

血压的各种指标对中老年人心脑血管病死亡事件的预测价值

目的 探讨中、老年人收缩压(SBP)、舒张压(DBP)、脉压(PP)、平均动脉压(MAP)水平对远期心脑血管死亡事件预测价值的差异.方法 对中老年人群10 786例进行基线调查,随访8年,应用Cox回归分析4个血压指标对远期心脑血管死亡事件预测价值的差异.结果 校正其他因素后,MAP和SBP分别为中、老年人最强烈的预测远期心脑血管病死亡事件危险程度的血压指标.中老年人4个血压指标每升高1个标准差(SD),其发生心脑血管病死亡危险的相对危险度(RR)由高到低分别为:(1)中年组:MAP(1.837),SBP(1.782),DBP(1.775),PP(1.750);(2)老年组: SBP(1.345),MAP(1.343),DBP(1.219),PP(1.215).结论 4个血压指标对心脑血管死亡事件的预测在不同的年龄段是不同的.中年人应着重于总体血压的控制,老年人应首先控制SBP.     

维持性血液透析患者认知功能与全因死亡及心脑血管病死亡关系的分析

目的研究维持性血液透析患者认知功能障碍发生率,探讨其与全因死亡、心脑血管病死亡的关系。方法蒙特利尔认知评估量表评估153例维持性血液透析患者认知功能,随访16个月,Cox比例风险模型分析全因死亡及心脑血管病死亡的危险因素,Kaplan-Meier估计累积生存率,生存率的比较采用Breslow检验。结果 153例受试者中认知功能障碍发生率56.86%;随访16个月间,各种原因死亡24人,其中心脑血管死亡15人,占总死亡人数的62.5%。Cox比例风险模型分析血磷、认知功能障碍是全因死亡的独立危险因素;年龄、认知功能障碍、透析累积时间是心脑血管疾病死亡的独立危险因素。与认知功能正常者相比,认知功能障碍者累积生存率及心脑血管疾病累积生存率均显著下降(P0.05)。结论认知功能障碍将可能成为维持性血液透析患者全因死亡、心脑血管病死亡的预测因子。     

051 脉压与老年人冠心病及心衰危险间关系初探

晚近发现,脉压(PP)为非老年人心血管终末事件的强力预测指标,然而其与老年人心血管终末事件间关系尚未见报道.本文首次就PP可否为老年人心血管终末事件[冠心病(CHD)发病、心衰(HF)发生、以及总死亡率]的独立预测指标进行了大样本分析. 对象与方法 2152例受试老人,年龄≥65岁.研究初始均无CHD和HF佐证,同时检测各自SBP、DBP,藉此计算PP.嗣后人均随访10年,观察分析PP与继后CHD发病率、HF发生率以及总死亡率间的相关关系. 结果 PP与使用利尿剂、β-阻滞剂、洋地黄药、口服降糖药,以及平均动脉压(MAP)、SBP、高血压均明显正相关,与DBP不相关.随访10年间,在2152例受试老人中,罹发CHD事件328例(CHD死亡154例,MI174例),罹发HF事件224例(HF死亡26例,HF住院者198例),不幸死亡包括CHD致死者共1046例.分析显示,PP与继后前述3事件间均存在明显的线型相关关系.如PP每递增1.33kPa,则CHD风险相应升高22%,HF风险相应升高22%,总死亡风险相应升高16%.校正年龄、性别、地区差异、各合并症以及CHD诸公认危险因素后,PP每递增1.33kPa,则CHD危险仍相应升高12%,HF危险亦相应升高14%,总死亡危险相应升高6%.且SBP及MAP亦均与罹发前述3事间正相关,DBP与之不相关.进一步将PP与其它血压参数(SBP、DBP、MAP、高血压等)一同进行分析后发现,PP仍与前述3事件明显正相关,与其它血压参数逆相关;若将PP汇同伍用药物及正常血压、高血压一同分析后显示,PP与纯收缩期高血压发病正相关,与舒张期高血压发生并不相关. 讨论本文结果表明,即使在老年人群,PP增大仍为其远期心血管终末事件(CHD、HF发病以及总死亡率高低)的强力独立危险因素和可靠预测指标. (袁志敏摘)     

空腹血糖升高的老年男性人群十年死亡率分析

目的 分析不同空腹血糖(FPG)水平的老年男性人群十年全因死亡率特别是心脑血管疾病死亡率的情况.方法 老年男性人群共1 572人, 按照基线FPG水平分为4组[FPG(mmol/L)＜ 5.6,5.6≤FPG＜6.1,6.1≤FPG＜7.0,FPG≥7.0]进行十年死亡率的分析.累积生存率的估计采用Kaplan-Meier 方法,生存率的比较采用log-rank检验.Logistic回归模型用于死亡率经各种危险因素调整的相对危险度(RR)表示以及与全因死亡及心脑血管死亡相关因素的分析.结果 各组十年全因死亡率[(12.6,19.5, 20.5, 27.9)/千人年]及心脑血管死亡率[(2.8, 7.7, 8.6, 14.0)/千人年]差异均有显著性(均P＜0.05),Logistic回归模型结果显示与老年人群全因死亡率有关的因素仅为年龄,而与心脑血管疾病死亡率密切相关的因素为年龄、体重指数、FPG以及心脑血管疾病病史.结论 在老年男性人群中心脑血管疾病是主要死亡原因之一,随着FPG水平的升高,老年男性人群全因死亡率及心脑血管疾病死亡率有所升高.     

人群脉压与心脑血管病发病的研究

目的：探讨人群中脉压（PP）与心脑血管病发病的危险因素、不同PP水平与心脑血管病发病的关系。方法：（1）研究对象：对福建省8个高血压防治点1991年时年龄≥40岁的对象进行8年跟踪随访,共随访9612人（男4748人,女4864人）,应达率为92.3%;（2）基线调查内容：一般情况、吸烟史、饮酒史、心脑血管既往史,测量血压、身高、体重等;随访内容：急性心肌梗死（AMI）与脑卒中史、发病与死亡。PP分为〈30mm-Hg、30～39mmHg、40～49mmHg、50～59mmHg、60～69mmHg和≥70mmHg6组。结果：（1）人群中不同年龄组PP存在明显差异（P〈0.01）,年龄与PP呈正相关关系（r=0.465,P〈0.01）。随体重指数增高PP随之升高（P〈0.05）。既往有脑卒中史者PP明显大于无脑卒中史者（P〈0.01）;（2）进入与PP有关的回归方程的因素按标准偏回归系数大小依次为：年龄（0.467）,体重指数（0.083）,脑卒中（0.077）,性别（0.079）,吸烟史（0.035）,P值除吸烟史=0.002外,余均=0.000;（3）AMI：8年中AMI发病率为0.8%,脑卒中发病率为4.1%,脑卒中的发病是AMI的5.6倍;无论是AMI或是脑卒中的发病率,在PP≥40mmHg各组均随PP升高而升高（P〈0.01）,尤其在脑卒中发病中更明显（P〈0.01）。PP在30～39mmHg组两种疾病的发病率最低。结论：本研究提示年龄、性别、体重指数、既往脑卒中史等因素与PP水平有密切关系。急性心肌梗塞、脑卒中的发病在PP≥40mmHg随PP增高而升高,尤其是脑卒中的发病;在30～39mmHg组发病率最低。PP是心脑血病的发病重要危险因素,PP的理想水平为30～39mmHg。     

胆红素对老年慢性心力衰竭全因死亡风险的预测价值及其影响因素

目的:研究血清胆红素对老年心力衰竭(心衰)患者全因死亡的预测价值及其影响因素。方法:对2007-01-2014-06住院入选的345名于中国中医科学院广安门医院心内科的老年心衰患者进行随访,终点事件为全因死亡,随访周期为730天。根据ROC曲线计算与死亡率相关的胆红素切值,根据此切值将患者分为胆红素正常组(组1)和胆红素升高组(组2),比较两组患者生存率的差异以及与胆红素相关的影响因素。结果:345例完成随访284例,失访61例(失访率17.68%)。死亡82例(23.77%)。单因素分析显示,总胆红素、直接胆红素、间接胆红素升高均可增加心衰患者死亡风险。总胆红素>23.5μmol/L、直接胆红素>4.60μmol/L、间接胆红素>17.70μmol/L均为心衰患者死亡的独立预测因素。通过Spearman相关分析显示,总胆红素、直接胆红素、间接胆红素与左室射血分数、血小板计数和极低密度脂蛋白呈负相关(P<0.05)。与右室内径、NT-proBNP、尿酸呈正相关(P<0.05)。多因素Cox风险比例回归显示,在考虑到年龄、性别、肾功能、血脂等因素后,以总胆红素为代表的胆红素系统对老年心衰患者的死亡率仍有独立的预测价值[HR:1.035,(95%CI:1.009-1.061),P=0.007]。结论:胆红素与老年心衰患者死亡独立相关,总胆红素、直接胆红素、间接胆红素升高均为老年心衰患者死亡的独立预测因素。心肌重构与胆红素升高关系密切。     

Association of pulse pressure,pulse pressure index,and ambulatory arterial stiffness index with kidney function in a cross‐sectional pediatric chronic kidney disease cohort from the CKiD study

The morbidity and mortality of adult and pediatric chronic kidney disease (CKD) and end‐stage renal disease (ESRD) populations are mainly driven by cardiovascular disease (CVD). Improving CVD outcomes focuses on risk assessment of factors including diastolic blood pressure (DBP), systolic blood pressure (SBP), left ventricular mass index (LVMI), pulse pressure (PP), and pulse pressure index (PPi), which is calculated as PP/SBP. These markers are also proven predictors of CKD progression; however, their role in children has not been established. This study aims to evaluate the relationship between PP, PPi, ambulatory arterial stiffness index (AASI), and proteinuria with kidney function in pediatric CKD patients; it is a retrospective analysis of 620 patients (1‐16 years) from the NIDDK Chronic Kidney Disease in Children (CKiD) registry. The authors analyzed data for three separate cohorts: an overall CKD as well as immunological versus non‐immunological cause for CKD groups. An inverse relationship was found between SBP, DBP, and PP with iGFR and LVMI in the overall CKD group. Our immunological CKD subgroup showed significantly higher serum creatinine, SBP, DBP, and PP values with significantly lower serum albumin levels compared to the non‐immunological group. There were no significant differences with iohexol‐based glomerular filtration rate (iGFR), LVMI, PPi, or high‐sensitivity C‐reactive protein (hs‐CRP) between the two groups. A subgroup analysis demonstrated that SBP, DBP, and PP all correlated significantly with LVMI in the immunological CKD patients but not the non‐immunological subgroup. Additionally, AASI data in the overall CKD population were significantly correlated with PP, PPi, and DBP. This study is one of the first to correlate noninvasive measurements of vascular compliance including PP, PPi, and AASI with iGFR and LVMI in a pediatric CKD cohort. Improving our understanding of surrogate markers for early CVD is integral to improving the care of pediatric CKD population as these patients have yet to develop the hard end points of ESRD, heart failure, myocardial infarction, or stroke.     

Pulse pressure measured at the level of the femoral artery,but not at the level of the aorta,carotid and brachial arteries,is associated with the incidence of coronary heart disease events in a population with a high prevalence of type 2 diabetes and impaired glucose metabolism – The Hoorn study

IntroductionCentral (aortic or carotid) pulse pressure (PP) is more strongly associated with local organ damage and possibly mortality than brachial PP.AimTo investigate for the first time the association of femoral (f) PP with all-cause mortality, and incident cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CerVD) events, as well as with markers of renal function (estimated glomerular filtration rate, eGFR, and microalbuminuria).MethodsWe used data from a population-based study, by design including 50% type 2 diabetes and impaired glucose metabolism (IGM). The baseline examination included non-invasive PP assessment at the brachial, aorta (Sphygmocor device), carotid and femoral (ultrasound distention waves calibrated by brachial mean and diastolic pressure) arteries.ResultsAfter 7.8 years of follow-up (n = 449, age: 68.9 ± 6.0 males: 52%), 66 participants had died, 102 had a CVD event, 45 a CHD event, and 31 a CerVD event. PP at all sites was associated with incident all-cause mortality and CVD events. Only fPP was, however, associated with incident CHD events, even after adjustment for CVD risk factors (HRs 1.31 [1.07–1.61 95% CIs]). No association between PP and incident CerVD events was found – possibly due to the small number of events. fPP was associated with renal function but this was similar to other PP indices. No interaction between each any local PP index and glucose metabolism status or renal function was present.ConclusionBeyond anatomical topography, local fPP provide important information related to CVD events. This possibility and the underlying mechanisms should be further investigated.     

代谢综合征患者脉压与心脑血管疾病的相关性

目的：探讨脉压（PP）、脉压指数（PPI）与代谢综合征（MS）患者心脑血管疾病的相关性。方法：选择近5年我院门诊和住院MS患者204例（男138例．女66例）,按PPI≤0．40、0．41～0．50、0．51～0．60、〉0．60分为4组,按PP≤40mmHg、41～60mmHg、61～80mmHg、〉80mmHg（1mmHg=0．133kPa）分为4组．分析各组间PP、PPI与心脑血管疾病发生率的相关性。结果：①不同组的PP、PPI在吸烟、饮酒、体重指数（BMI）、血糖、腹围、舒张压（DBP）、甘油三脂（TG）、高密度脂蛋白-胆固醇（HDL-C）、及低密度脂蛋白-胆固醇（LDL—C）方面无显著差别（P〉0．05）,在年龄、收缩压（SBP）方面差异有显著性（P〈0．05～〈0．01）;不同组的PP及PPI的左室肥厚、冠心病、心功能不全、脑卒中发生率有显著性差异（P均〈0．05）;左室肥厚、冠心病、心功能不全、脑卒中的发生率与患者年龄、收缩压、脉压、脉压指数有显著相关性[EXP（B）=1．614～3．340,P均〈0．05]。结论：MS患者心脑血管疾病与年龄、SBP、PP、PPI等因素有关,与PPI的关系更为密切。     

Systolic and diastolic blood pressure, mean arterial pressure and pulse pressure for prediction of cardiovascular events and mortality in a Middle Eastern population

We compared systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) as independent predictors of cardiovascular disease (CVD), total and CVD mortality among an Iranian population. The study conducted among 5991 subjects aged ≥ 30 years without baseline CVD and antihypertensive medication. The mean of two measurements of SBP and DBP, in sitting position, was considered the subject's blood pressure. During a median follow-up of 8.7 years, 346 CVD and 157 deaths, 63 attributed to CVD, occurred. Hazard ratios (HRs) of each outcome were calculated for a one standard deviation (SD) increase in each blood pressure (BP) measures. In multivariate models, all BP measures were associated with increased risk of CVD regardless of age. In those aged < 60 years, SBP, DBP, PP and MAP were associated with total mortality (p < 0.05), but in subjects aged ≥ 60 years, only SBP and PP increased risk of total mortality significantly. In multivariate analyses, a 1SD increase in SBP, PP and MAP were associated with 35%, 31% and 28% increased risk of CVD mortality (p < 0.05). In terms of fitness and discrimination of models, DBP, PP and MAP were not superior to SBP. In conclusion, our findings provided further evidence from a Middle Eastern population, in support of SBP predictability for CVD events and CVD and all-cause mortality compared with other BP measures.     

Pulse pressure predicts cardiovascular risk in patients with type 2 diabetes mellitus

BACKGROUND: Pulse pressure (PP), a marker of arterial stiffness, is a better predictor of coronary heart disease (CHD) risk than systolic blood pressure (SBP) or diastolic blood pressure (DBP) in older adults. Whether this is also true in subjects with type 2 diabetes, who are at increased risk for cardiovascular disease, is unknown. METHODS: Data on 2911 type 2 diabetic subjects relating to blood pressure (BP), other risk factors, and cardiovascular events were abstracted from The Cardiff Diabetes Database. Logistic regression was used to assess the relationship among BP components and the risk of CHD, cerebrovascular (CVD), and peripheral vascular (PVD) events after correction for age, gender, cholesterol, and smoking status. RESULTS: In the 4-year follow-up period there were 574 CHD, 168 CVD, and 157 PVD events. Both PP and SBP, but not DBP, were positively associated with the risk of all event types. However, PP emerged as the best predictor of CHD events, and SBP as the best predictor of CVD and PVD events. Total and HDL-cholesterol were the most important variables associated with PP after age. CONCLUSIONS: In summary, PP is a better predictor of CHD events than SBP in persons with type 2 diabetes, but the converse is true for CVD and PVD.     

Blood pressure control status and effects of pravastatin on cardiovascular events occurrence in patients with dyslipidaemia

Dyslipidaemia is often associated with hypertension, and many clinical trials have shown that lipid-lowering therapy and strict blood pressure (BP) control are important for preventing cardiovascular disease (CVD). However, few reports describe the effect of statins on CVD occurrence in relation to long-term BP control. In the present analysis, we investigated the effects of baseline BP and follow-up BP control on the occurrence of CVD in patients enrolled in the MEGA Study. We investigated whether BP values provide more accurate prediction of the occurrence of CVD, including cerebrovascular disease/transischemic attack (CVA/TIA), and the effect of pravastatin on CVA/TIA. The risk for CVA/TIA and other CVD increased significantly (P≤0.001) as the severity of hypertension increased. In contrast, pravastatin reduced the onset of CVA/TIA, regardless of the BP controlled. The mean BP was a more accurate predictor of CVD than a one-time BP value. In patients with mild-to-moderate dyslipidaemia, elevated BP increases the risk for CVA/TIA and other CVD, and rigorous BP control was important for preventing CVD, in particular CVA/TIA. The 12-month mean BP is useful to avoid attenuation to determine the association between CVD and BP. Pravastatin prevented CVA/TIA, regardless of BP controlled.     

The relationship between urinary cations obtained from the INTERSALT study and cerebrovascular mortality.

An epidemiological study on the relationship between 24 hour urinary sodium, potassium, calcium, magnesium and creatinine (Creat), as obtained from the INTERSALT study, and cerebrovascular disease (CVA) mortality in the age-standardised group 45-74 years, was conducted using data from 25 countries worldwide. A significant positive relationship was observed by multivariate analysis between cerebrovascular disease mortality and 24 hour urinary Na excretion in men, with Na/K ratio in women and with Na/Creat ratio in all groups. A significant negative correlation was found between the 24 hour urinary magnesium excretion and CVA mortality in men and in men and women averaged, while 24 hour urinary potassium excretion correlated significantly and negatively with CVA mortality in women. No significant relationship between systolic and diastolic blood pressure, 24 hour urinary calcium excretion and BMI with CVA mortality could be established. A log10 transformation revealed a significant positive relationship between Ca/Mg ratio with CVA mortality in men as well as in the group of men and women averaged. A significant negative correlation between CVA mortality and 24 hour creatinine excretion was found. This relationship was stronger in men and could point to a protective effect of protein intake. The findings also point to a direct relationship between dietary cation intake and CVA mortality.     

Relative role of systolic,diastolic and pulse pressure as risk factors for cardiovascular events in the Brisighella Heart Study

OBJECTIVE: The objective of this study was to determine the contribution of elevated blood pressure parameters to the long-term incidence of cardiovascular events. DESIGN: A prospective, population-based longitudinal epidemiological cohort. SETTINGS: The population of the town of Brisighella. PATIENTS: The Brisighella Heart Study involved 2939 randomly selected residents of Brisighella, Italy aged 14 to 84 years, free of cardiovascular (CV) disease at enrollment and followed since 1972. Subjects were clinically evaluated at baseline and every 4 years following enrollment when extensive clinical and laboratory data were obtained in addition to the assessment of morbidity and mortality. MAIN OUTCOME MEASUREMENTS: The Cox regression analysis, adjusted for the main risk factors for CV disease was used to determine the independent prognostic significance of systolic, (SBP), diastolic (DBP), and pulse pressure (PP). The events of interest were coronary heart disease (CHD) and cerebrovascular disease (CVD). RESULTS: Adjusted hazard ratios (HRs) for combined CHD + CVD at SBP categories of 120-139, 140-159, and 159 mmHg were 1.45 [95% confidence interval, (CI), P= 0.035], 1.88 (95% CI, P= 0.0008), and 2.31 (95% CI, P<0.0001), respectively. For DBP ranges of 70-79, 80-89, and 89 mmHg, HRs were 0.91 (95% CI, P= 0.677), 1.33 (95% CI, P= 0.169), and 1.65 (95% CI, P= 0.029), respectively. PP ranges from 54-67 and 67 mmHg were associated with HRs of 1.23 (95% CI, P= 0.149), and 1.38 (95% CI, P= 0.030), respectively. Similar results were seen for CVD and CHD as separate endpoints. CONCLUSIONS: The present study demonstrates that SBP is a stronger predictor of cardiovascular events than DBP in the Brisighella population. The added prognostic significance of PP is also demonstrated, particularly if PP exceeds 67 mmHg.     

Association of visit‐to‐visit blood pressure variability with the risk of all‐cause mortality and cardiovascular events in general population

The association between blood pressure variability (BPV) and the risk of all‐cause mortality and cardiovascular diseases (CVD) is not well understood. The Kailuan study is a prospective longitudinal cohort study on cerebrovascular events and cardiovascular factors. In this study, resting blood pressure was measured at baseline and every 2 years from 2006 to 2007. BPV is mainly defined as the coefficient of variation (CV). Hazard ratio (HR), with 95% confidence intervals (CI) was calculated using Cox regression model. Among 52 387 participants, we identified 1817 who ended up with all‐cause death and 1198 with CVD. Each 4.68% increase in BPV was associated with a 13% increase in the risk of mortality (HR = 1.13, 95% CI = 1.09‐1.18) and a 7% increase in CVD (HR = 1.07, 95% CI = 1.02‐1.13), respectively. After adjustment of confounding factors, the HR of comparing participants in the highest versus lowest quartile of CV of systolic blood pressure (SBP) was 1.37 (1.19, 1.57) for all‐cause death, 1.18 (1.01, 1.39) for CVD. Similar results were also observed when BPV was measured by different parameters. We concluded that visit‐to‐visit BPV was associated with all‐cause death and cardiovascular and cerebrovascular events in Chinese general population.     

脂质代谢异常与慢性肾脏病合并心血管疾病的研究进展

慢性肾脏病(CKD)的患病率逐年上升,而心血管疾病(CVD)是导致其死亡的主要原因。CKD患者往往同时合并脂质代谢异常,这是促进CVD发生发展的重要因素,但CKD患者的脂质代谢异常与CVD发病率和死亡率之间的关系有其特殊性,各类降脂治疗能否有效改善CKD患者的CVD也存在争议。因此,文章就脂质代谢异常与CKD患者合并CVD发生的病理生理机制及相关性作一综述,这对降低CKD患者CVD发生率及改善患者预后具有十分重要的意义。