Levels of blood pressure are associated with the prevalence of stroke in hypertension patients

doi:10.3877/cma.j.issn.2095-9141.2015.05.002

Abstract

Abstract:

Objective

To analyze both blood pressure and other risk factors associated with the prevalence of stroke in hypertension patients for the prevention of an initial stroke and future stroke among survivors of stroke.

Methods

Detailed information of 2 396 patients with essential hypertension were collected including age, gender, body mass index (BMI), blood pressure (BP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting glucose (GLU), homocysteine (Hcy), and past history of diabetes mellitus, hyperlipemia, stroke and hyperhomocysteinemia. The detectable interaction between BP and stratified factors is examined by adding the BP × stratified factors cross-product to a logistic regression analysis of the hypertension participants.

Results

A total of 2 396 patients with primary hypertension were enrolled in this study. Hypertension patients with BP≥140/90 mmHg had a significantly higher fasting GLU(6.13±1.91 vs. 6.45±2.24, t=2.652, P=0.003), lower HDL-C level (39.27±11.97 vs. 36.28±11.45, t=4.702, P=0.000) than that of patients with BP<140/90 mmHg, as was also their exposure to diabetes mellitus, stroke and hyperhomocysteinemia (χ²=4.910, 140.630, 44.284, respectively, P<0.05). An increasing level of blood pressure was associated with higher stroke risk the condition of age range 45-74, and full scope of BMI, fasting GLU, non-HDL-C, TG and Log Hcy(P<0.05).

Conclusions

Among the hypertension participants, significant interaction on stroke risk was observed between blood pressure and Log Hcy. Age and gender interacted with non-HDL-C and TG in hypertension patients with stroke.

Key words: Blood pressure, Stroke, Homocysteine, Dyslipidemia

Zhenkun Zong, Hui Pang, Bing Han, Qiang Fu. Levels of blood pressure are associated with the prevalence of stroke in hypertension patients[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2015, 01(05): 4-8.

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Figures/Tables 5

References 20

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变量		降压达标(n=394)	降压未达标(n=2002)	t/χ²值	P值
年龄(岁)		60.9±8.0	60.7±8.9	0.456	0.624
男[n(%)]		250(63.45)	1224(61.14)	0.649	0.388
BMI (kg/m²)		24.73±3.45	24.65±3.48	0.418	0.667
吸烟[n(%)]		185(46.95)	889(44.41)	0.765	0.352
饮酒[n(%)]		146(37.06)	738(36.86)	0.000	0.942
SBP (mmHg)		124.94±9.84	161.31±21.75	32.539	0.000
DBP (mmHg)		77.45±7.06	94.93±13.05	26.037	0.000
空腹GLU (mmol/L)		6.13±1.91	6.45±2.24	2.652	0.003
TC (mmol/L)		4.95±0.95	4.87±1.03	1.498	0.134
HDL?C (mmol/L)		1.01±0.31	0.94±0.30	4.702	0.000
非HDL?C (mmol/L)		3.94±0.91	3.93±0.98	0.125	0.894
TG (mmol/L)		1.80±0.93	1.85±0.98	0.874	0.383
Hcy (μmol/L)		17.33±14.85	18.02±13.38	0.918	0.356
基础疾病[n(%)]		?	?	?	?
?	糖尿病	84(21.32)	537(26.82)	4.910	0.023
?	高脂血症	199(50.51)	954(47.65)	0.964	0.300
?	脑卒中	166(42.13)	1 458(72.83)	140.630	0.000
?	高Hcy血症	169(42.89)	1 224(61.14)	44.284	0.000

变量		降压达标(n=394)	降压未达标(n=2002)	t/χ²值	P值
年龄(岁)		60.9±8.0	60.7±8.9	0.456	0.624
男[n(%)]		250(63.45)	1224(61.14)	0.649	0.388
BMI (kg/m²)		24.73±3.45	24.65±3.48	0.418	0.667
吸烟[n(%)]		185(46.95)	889(44.41)	0.765	0.352
饮酒[n(%)]		146(37.06)	738(36.86)	0.000	0.942
SBP (mmHg)		124.94±9.84	161.31±21.75	32.539	0.000
DBP (mmHg)		77.45±7.06	94.93±13.05	26.037	0.000
空腹GLU (mmol/L)		6.13±1.91	6.45±2.24	2.652	0.003
TC (mmol/L)		4.95±0.95	4.87±1.03	1.498	0.134
HDL?C (mmol/L)		1.01±0.31	0.94±0.30	4.702	0.000
非HDL?C (mmol/L)		3.94±0.91	3.93±0.98	0.125	0.894
TG (mmol/L)		1.80±0.93	1.85±0.98	0.874	0.383
Hcy (μmol/L)		17.33±14.85	18.02±13.38	0.918	0.356
基础疾病[n(%)]		?	?	?	?
?	糖尿病	84(21.32)	537(26.82)	4.910	0.023
?	高脂血症	199(50.51)	954(47.65)	0.964	0.300
?	脑卒中	166(42.13)	1 458(72.83)	140.630	0.000
?	高Hcy血症	169(42.89)	1 224(61.14)	44.284	0.000

变量		血压(mmHg)				P值(趋势分析)	P值(交互作用)
变量		<140/90(n=394)	140～159/90～99(n=827)	160～179/100～109(n=597)	≥180/110(n=578)	P值(趋势分析)	P值(交互作用)
年龄(岁)		?	?	?	?	?	0.341
?	≤44(n=101)	1	/	/	/	0.206	?
?	45～59(n=860)	1	1.584(1.010～2.485)	6.501(3.834～11.024)	34.103(16.798～69.233)	0.000	?
?	60～74(n=1352)	1	1.597(1.122～2.272)	5.344(3.584～7.968)	25.839(14.448～46.213)	0.000	?
?	≥75(n=83)	1	/	/	/	0.076	?
BMI(kg/m²)		?	?	?	?	?	0.318
?	<24(n=1034)	1	1.608(1.064～2.430)	7.965(4.853～13.075)	33.870(16.160～70.987)	0.000	?
?	24～27.9(n=992)	1	1.518(1.026～2.247)	4.911(3.110～7.756)	25.970(13.014～51.825)	0.000	?
?	≥28(n=370)	1	0.866(0.447～1.678)	2.824(1.380～5.778)	15.564(6.484～37.358)	0.000	?
空腹GLU(mmol/L)		?	?	?	?	?	0.109
?	<6.1(n=1475)	1	1.188(0.863～1.635)	4.178(2.906～6.007)	30.490(16.535～56.225)	0.000	?
?	6.1～6.9(n=409)	1	2.625(1.335～5.164)	9.919(4.599～21.394)	32.884(12.908～83.775)	0.000	?
?	≥7.0(n=512)	1	1.502(0.829～2.721)	10.209(4.271～24.402)	13.540(5.862～31.276)	0.000	?
非HDL～C(mmol/L)		?	?	?	?	?	0.646
?	<160(n=1437)	1	1.288(0.922～1.799)	4.915(3.287～7.350)	28.213(15.045～52.903)	0.000	?
?	160～189(n=611)	1	2.374(1.390～4.054)	7.739(4.275～14.008)	42.952(18.326～100.671)	0.000	?
?	≥190(n=348)	1	0.826(0.376～1.815)	3.816(1.609～9.048)	12.649(4.627～34.581)	0.000	?
TG(mmol/L)		?	?	?	?	?	0.543
?	<150(n=1288)	1	1.423(0.991～2.045)	5.479(3.596～8.348)	27.952(15.500～50.410)	0.000	?
?	150～199(n=485)	1	1.748(0.958～3.187)	10.471(5.115～21.437)	19.606(8.272～46.470)	0.000	?
?	≥200(n=623)	1	1.315(0.793～2.180)	3.597(2.015～6.423)	59.113(17.201～203.144)	0.000	?
Log Hcy		?	?	?	?	?	0.000
?	<1.09(n=783)	1	1.305(0.814～2.092)	3.935(2.323～6.668)	18.520(9.412～36.441)	0.000	?
?	1.09～1.23(n=862)	1	1.438(0.936～2.210)	6.031(3.661～9.935)	28.930(14.040～59.609)	0.000	?
?	>1.23(n=751)	1	1.397(0.877～2.225)	6.551(3.644～11.780)	44.399(15.285～128.964)	0.000	?

变量		血压(mmHg)				P值(趋势分析)	P值(交互作用)
变量		<140/90(n=394)	140～159/90～99(n=827)	160～179/100～109(n=597)	≥180/110(n=578)	P值(趋势分析)	P值(交互作用)
年龄(岁)		?	?	?	?	?	0.341
?	≤44(n=101)	1	/	/	/	0.206	?
?	45～59(n=860)	1	1.584(1.010～2.485)	6.501(3.834～11.024)	34.103(16.798～69.233)	0.000	?
?	60～74(n=1352)	1	1.597(1.122～2.272)	5.344(3.584～7.968)	25.839(14.448～46.213)	0.000	?
?	≥75(n=83)	1	/	/	/	0.076	?
BMI(kg/m²)		?	?	?	?	?	0.318
?	<24(n=1034)	1	1.608(1.064～2.430)	7.965(4.853～13.075)	33.870(16.160～70.987)	0.000	?
?	24～27.9(n=992)	1	1.518(1.026～2.247)	4.911(3.110～7.756)	25.970(13.014～51.825)	0.000	?
?	≥28(n=370)	1	0.866(0.447～1.678)	2.824(1.380～5.778)	15.564(6.484～37.358)	0.000	?
空腹GLU(mmol/L)		?	?	?	?	?	0.109
?	<6.1(n=1475)	1	1.188(0.863～1.635)	4.178(2.906～6.007)	30.490(16.535～56.225)	0.000	?
?	6.1～6.9(n=409)	1	2.625(1.335～5.164)	9.919(4.599～21.394)	32.884(12.908～83.775)	0.000	?
?	≥7.0(n=512)	1	1.502(0.829～2.721)	10.209(4.271～24.402)	13.540(5.862～31.276)	0.000	?
非HDL～C(mmol/L)		?	?	?	?	?	0.646
?	<160(n=1437)	1	1.288(0.922～1.799)	4.915(3.287～7.350)	28.213(15.045～52.903)	0.000	?
?	160～189(n=611)	1	2.374(1.390～4.054)	7.739(4.275～14.008)	42.952(18.326～100.671)	0.000	?
?	≥190(n=348)	1	0.826(0.376～1.815)	3.816(1.609～9.048)	12.649(4.627～34.581)	0.000	?
TG(mmol/L)		?	?	?	?	?	0.543
?	<150(n=1288)	1	1.423(0.991～2.045)	5.479(3.596～8.348)	27.952(15.500～50.410)	0.000	?
?	150～199(n=485)	1	1.748(0.958～3.187)	10.471(5.115～21.437)	19.606(8.272～46.470)	0.000	?
?	≥200(n=623)	1	1.315(0.793～2.180)	3.597(2.015～6.423)	59.113(17.201～203.144)	0.000	?
Log Hcy		?	?	?	?	?	0.000
?	<1.09(n=783)	1	1.305(0.814～2.092)	3.935(2.323～6.668)	18.520(9.412～36.441)	0.000	?
?	1.09～1.23(n=862)	1	1.438(0.936～2.210)	6.031(3.661～9.935)	28.930(14.040～59.609)	0.000	?
?	>1.23(n=751)	1	1.397(0.877～2.225)	6.551(3.644～11.780)	44.399(15.285～128.964)	0.000	?

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