摘要目的 探讨肱-踝脉搏波速度( baPWV)水平对高血压前期人群进展至高血压的预测价值.方法 此研究对象来自2006年9月-2007年12月在本院进行年度体检的浙江地区健康的35～55岁男性公务员,符合高血压前期诊断标准的研究对象2580例,经4年左右随访最终2451例(95％)作为观察队列,纳入统计分析.用logistic回归分析基线baPWV水平对高血压前期人群进展至高血压的预测价值.结果 (1)队列中208例在4年随访中进展至高血压,占8.5％.(2)进展至高血压组与未达高血压组基线资料比较,高血压家族史、心率、总胆固醇比较,差异无统计学意义(P＞0.05),其他各指标均有差异,其中baPWV、收缩压、舒张压差异有统计学意义(P ＜0.001).(3)按基线baPWV每变化一个标准差(140 cm/s)为自变量,用多因素logistic回归分析baPWV与进展至高血压的相关性,仅校正年龄(模型1)与校正全部其他基线资料变量(模型3)后,OR及95％ CI分别为2.20(1.78 ～2.62),(P＜0.001),1.49(1.15 ～1.73),(P＜0.01).(4)根据基线baPWV值四分位数分组.多因素logistic回归分析,以baPWV最低组为基准,仅校正年龄最高组OR及95％ CI为10.9(5.1～22.7)(P＜0.001)；校正全部其他变量后OR及95％ CI为2.6(1.2～6.1) (P＜0.05),仍是进展至高血压的独立预测因子.结论 baPWV是本研究相关高血压前期人群进展至高血压的独立预测因子.baPWV或是一种在大规模高血压前期人群中筛选出高血压高危个体并给予干预的有效方法.

abstractsObjective To investigate the value of brachial-ankle pulse wave velocity (baPWV) in the prediction of hypertension in middle-aged men with prehypertension.Methods A total of 2580 middle-aged (35 to 55 years old ) prehypertensive individuals who underwent health check-up during September 2006 and December 2007 in our hospital were recruited for this prospective cohort study.After a 4-year follow-up,2451subjects entered final analysis.Logistic regression analysis was used to assess the value of baPWV in the prediction of hypertension.Results (1) Two hundred and eight subjects (8.5％ )developed hypertension after 4-year follow-up study.( 2 ) At baseline,no significant differences of family history of hypertension,heart rate and total cholesterol were found between normotensive and hypertensive subjects (P ＞0.05 ).(3) Logistic regression analysis showed that in age-adjusted model (Model1),the odds ratio (OR) and 95％ confidence interval (CI) of baPWV (140 cm/s) was 2.20 (1.78 to 2.62 )( P ＜0.01) ; while in multi-factor adjusted model ( Model 3 ),OR and 95c％c CI of baPWV was I.49 (1.15 to 1.73) (P ＜ 0.01).(4) Subjects were stratified by quartiles of baPWV at baseline.OR and 95％ CI of hypertension in those of highest quartile was higher than those of lowest quartile ( Model1:OR =10.9,95％CI 5.1-22.7,P＜0.01; Model 3:0R=2.6,95％CI1.2 -6.1,P＜0.05).Conclusion baPWV could be an independent predictor of hypertension among prehypertensive populations.