中国卒中杂志2017，Vol.12Issue(6)：496-500,5.DOI:10.3969/j.issn.1673-5765.2017.06.006
限制性立方样条评估抗高血压治疗与卒中的J型曲线
Evaluation of the J Shaped Curve by Restricted Cubic Spline between the Antihypertension Treatment and Stroke
任海丹 1吕奇玮 1王书军 1卢云 1安仕广 1夏芳2
作者信息
- 1. 200233 上海上海市徐汇区虹梅街道社区卫生服务中心
- 2. 上海市徐汇区大华医院心内科
- 折叠
摘要
Abstract
Objective To assess the J shaped curve between the value of blood pressure and the occurrence of stroke in the antihypertension treatment. Methods A retrospective analysis was conducted in the 2059 patients accepted antihypertension treatment in outpatients or hospitalized from January 2009 to October 2013. The restricted cubic spline (RCS) fitting Cox regression model was used to evaluate the relationship between different blood pressure cut-off value and stroke. The Kaplan-Meier methods was used to assess the incidence of stroke during follow-up, and Cox proportion risk model was used to analyze the independent risk factors for stroke. Results The 1, 3, 5 year cumulative stroke incidence rates in the whole patients were 2.5%, 8.8%and 16.6%, respectively. There existed a nonlinear relationship between blood pressure value and the occurrence of stroke assessed by the RCS fitting Cox model. The risk rates for stroke increased in the patients whose systolic blood pressure (SBP) <110 mmHg or >150 mmHg and diastolic blood pressure (DBP) <60 mmHg or >90 mmHg. The Cox proportional hazard model by multivariate analysis found that smoking history (HR 2.32, 95%CI 1.36-3.13, P=0.009), diabetes(HR 2.07, 95%CI 1.18-3.05, P=0.011), atrial fibrillation (HR 1.89, 95%CI 1.16-2.98, P=0.014), SBP < 110 mmHg (HR 1.62, 95%CI 1.11-2.24, P=0.032) or >150 mmHg (HR 1.79, 95%CI 1.21-2.72, P=0.013) and carotid artery stenosis (HR 2.47, 95%CI 1.37-4.18, P=0.008) were independent factors for stroke. Conclusion There existed the J shaped curve between blood pressure and stroke in the course of antihypertensive treatment. The incidence of stroke increased in the patients of SBP <110 mmHg or>150 mmHg.关键词
高血压/卒中/J型曲线/限制性立方样条Key words
Hypertension/Stroke/J shaped curve/Restricted cubic spline引用本文复制引用
任海丹,吕奇玮,王书军,卢云,安仕广,夏芳..限制性立方样条评估抗高血压治疗与卒中的J型曲线[J].中国卒中杂志,2017,12(6):496-500,5.
