摘要
目的 探讨昆山地区社区老年高血压人群血浆致动脉粥样硬化指数(AIP)与心血管疾病发病风险的关系.方法 本研究共纳入在社区接受年度健康检查的21 226例老年高血压患者为研究对象.收集基线年龄、性别、吸烟史、高血压、糖尿病和心血管疾病史等人口学信息,对患者身高、体质量、体质量指数(BMI)、腰围、血压和空腹血糖、血脂进行测量.记录血脂指标,包括AIP、血脂综合指数(LCI)、Castelli风险指数1(CRI-Ⅰ)和Castelli风险指数2(CRI-Ⅱ).随访观察终点是首次发生心血管疾病.采用多因素Cox比例风险模型探讨基线AIP水平与高血压人群心血管疾病发病风险的关系.结果 中位随访时间5.62(3.53,7.16)年后,3 179例出现心血管疾病事件.Cox回归分析结果显示,不调整混杂因素时,AIP基线水平与心血管疾病发病风险呈正相关(HR=1.16,95％CI:1.02～1.32).进一步调整年龄、性别、BMI、腰围、血压、血糖、吸烟史、糖尿病史后,AIP水平与心血管疾病发病风险仍密切相关.限制性立方样条分析提示AIP与心血管疾病风险总体呈线性相关.Kaplan-Meier生存曲线显示,与最低分位比较,最高分位血管疾病累积风险更高(P＜0.001).结论 在昆山地区社区老年高血压人群中,基线AIP水平与心血管疾病发病风险有关.监测AIP水平可能有助于预测、评估心血管疾病的发病风险.
Abstract
Objective To investigate the relationship between plasma atherosclerosis index(AIP)and the risk of cardiovascular disease in community elderly hypertensive patients in Kunshan area.Methods A total of 21,226 elderly hypertensive patients who underwent annual health exami-nations in community were enrolled in this study.Demographic information such as baseline age,gen-der,smoking history,hypertension,diabetes,and history of cardiovascular disease were collected.Patients'height,body weight,body mass index(BMI),waist circumference,blood pressure,fasting blood glucose,and blood lipids were measured.Lipid indicators including AIP,lipid composite index(LCI),Castelli risk index-Ⅰ(CRI-Ⅰ),and Castelli risk index-Ⅱ(CRI-Ⅱ)were recorded.The primary endpoint was the first occurrence of cardiovascular disease.The multivariate Cox proportional hazards model was used to explore the relationship between baseline AIP level and cardiovascular dis-ease risk in hypertensive patients.Results After a median follow-up period of 5.62(3.53,7.16)years,3,179 patients occurred cardiovascular disease events.Cox regression analysis showed that a higher baseline AIP level was positively correlated with cardiovascular disease risk without adjusting for confounding factors(HR=1.16;95％CI,1.02 to 1.32).After further adjustment for age,gender,BMI,waist circumference,blood pressure,blood glucose,smoking history,and diabetes history,the AIP level remained closely related to cardiovascular disease risk.Restricted cubic spline analysis sug-gested an overall linear relationship between AIP and cardiovascular disease risk.Kaplan-Meier survival curve analysis showed that compared with the lowest quartile,the cumulative risk of cardiovascular disease was higher in the highest quartile(P＜0.001).Conclusion In community elderly hyper-tensive patients in Kunshan area,baseline AIP level is associated with cardiovascular disease risk.Monitoring AIP levels may aid in predicting and assessing the risk of cardiovascular disease.
维普
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