收缩压、舒张压与心血管风险的关系
The Relationship of Systolic and Diastolic Blood Pressure to Cardiovascular Disease Risk: Observational Data
Prevalence of Hypertension in the US
Percent hypertensive
18-29
Based on NHANES III (phase 1 and 2)
Hypertension defined as blood pressure ?140/90 mmHg or treatment
30-39
40-49
50-59
60-69
70-79
80+
Age
3 %
9 %
18 %
38 %
51 %
66 %
72 %
JNC-VI. Arch Intern Med. 1997;157:2413-2446.
Risk of hypertension (%)
Residual lifetime risk of developing hypertension among people with blood pressure <140/90 mmHg
Years
Lifetime Risk of Developing Hypertension Beginning at Age 65
Men
Women
Vasan RS, et al. JAMA. 2002; 287:1003-1010.
Copyright 2002, American Medical Association.
Mortality According to Blood Pressure in Men Age 50 to 69
Society of Actuaries. Blood Pressure Study, 1939.
Ratio (%) of actual to expected mortality
Systolic blood pressure (mmHg)
Diastolic blood
pressure (mmHg)
Age-adjusted annual incidence of CHD per 1000
Based on 30 year follow-up of Framingham Heart Study subjects free of coronary heart disease (CHD) at baseline
Systolic blood pressure (mmHg)
Blood Pressure and Risk for Coronary Heart Disease in Men
Diastolic blood pressure (mmHg)
Age 65-94
Age 35-64
Age 65-94
Age 35-64
Framingham Heart Study, 30-year Follow-up. NHLBI, 1987.
Relative risk of
CHD mortality
He J, et at. Am Heart J. 1999;138:211-219.
Copyright 1999, Mosby Inc.
<112 <71
Risk of CHD Death According to SBP and DBP in MRFIT
Decile
112- 71-
118- 76-
121- 79-
125- 81-
129- 84-
132- 86-
137- 89-
142- 92-
>151 >98
(lowest 10%)
(highest 10%)
SBP (mmHg)
DBP (mmHg)
Systolic blood pressure (SBP)
Diastolic blood pressure (DBP)
CHD=coronary heart disease
Relative risk of stroke death
<112 <71
Risk of Stroke Death According to SBP and DBP in MRFIT
Decile
112- 71-
118- 76-
121- 79-
125- 81-
129- 84-
132- 86-
137- 89-
142- 92-
>151 >98
(lowest 10%)
(highest 10%)
SBP (mmHg)
DBP (mmHg)
Systolic blood pressure (SBP)
Diastolic blood pressure (DBP)
He J, et at. Am Heart J. 1999;138:211-219.
Copyright 1999, Mosby Inc.
Age-adjusted annual CVD event rate per 1000
Wilking SV et al. JAMA. 1988;260:3451-3455.
Men
Women
Isolated Systolic Hypertension and CVD Risk in Framingham
ISH BP ?160/<95 mmHg
BP <140/95 mmHg
82
43
33
2.4
18
2.5
CVD=cardiovascular disease ISH=isolated systolic hypertension
P<0.001 for difference between both men and women with ISH and blood pressure (BP) <140/95 mmHg