Correlation between blood pressure development trajectory and arrhythmia in the elderly with hypertension
Objective To investigate the development trajectory of blood pressure in elderly people in China and its correlation with arrhythmia,so as to provide an evaluation method for preventing arrhythmia.Methods A total of 3 742 people who met the inclusion criteria in the 8 longitudinal data periods of the Chinese Longitudinal Healthy Longevity Survey(CLHLS)cohort study database from 1998 to 2018 were selected as the research objects.A group-based trajectory model for blood pressure development was constructed by R software,and the final model was de-termined according to the minimum Bayesian information criterion.Cox proportional hazards regression model was used to analyze the risk of arrhythmia in different trajectory groups,and sensitivity analysis was performed to ana-lyze the primary outcome.Results The development trajectories of systolic blood pressure(SBP)were determined in 2 subgroups and diastolic blood pressure(DBP)were determined in 3 subgroups,which were labeled as low-stable SBP group(3 067 cases,81.96％),high-high SBP group(675 cases,18.04％),and low-low DBP group(365 ca-ses,9.75％),medium-low DBP group(1 265 cases,33.81％),high-stable DBP group(2 112 cases,56.44％).With the increase of age,the SBP increased in the high-high SBP group,the DBP decreased in the low-low DBP group and medium-low DBP group,and the blood pressure in low-stable SBP group and high-stable DBP group re-mained stable.After adjusting for sex,age,ethnicity,drinking,smoking,and self-rated health,Cox regression showed that the risk of arrhythmia in the high-high SBP group was 1.94 times(95％CI 1.31-2.88,P＜0.001)higher than that in low-stable SBP group.The risk of arrhythmia in the high-stable DBP group was 0.49 times(95％CI 0.30-0.81,P=0.005)lower than that in the low-low DBP group.The results of sensitivity analysis were consistent with those of Cox regression analysis.The risk of arrhythmia in the high-high SBP group was higher than that in the low-stable SBP group.The risk of arrhythmia in the high-stable DBP group was lower than that in the low-low DBP group.Conclusion The development trajectory of blood pressure in the elderly with hyperten-sion,especially the development trajectory of SBP,may be a predictor of arrhythmia,and high SBP will increase the risk of arrhythmia.
hypertensionthe elderlyarrhythmiasystolic blood pressurediastolic blood pressuretraj-ectory model
NETL
NSTL
万方数据
