摘要
目的探讨心脏代谢指数(cardiometabolic index,CMI)与中国老年人群高血压亚型的关联性,为高血压分型及个性化干预提供科学依据。方法采用横断面研究,纳入2015年1月至12月在山东大学齐鲁医院就诊的1022例老年患者(≥60岁),排除继发性高血压及严重并发症者。通过标准化流程测量血压、腰围、血脂等指标。采用多元logistic回归分析CMI与亚型的关联,并基于性别、吸烟、年龄、脉搏及代谢指标分层分析。结果SDH组CMI显著高于其他亚型(P<0.01),腰围、体质指数、甘油三酯与三型高血压均呈正相关(P<0.05)。多变量模型显示,CMI是高血压亚型的独立危险因素(SDH OR=6.14,IDH OR=4.14,ISH OR=3.28,均P<0.01)。分层分析表明,女性CMI与所有亚型相关(P<0.01),男性仅与IDH和SDH相关;非吸烟者CMI效应更强(SDH OR=9.56,P<0.001)。高血糖及不同浓度的低密度脂蛋白胆固醇水平均加剧CMI对SDH的影响。结论CMI可能是老年高血压亚型的独立危险因素。性别、代谢状态及吸烟行为的差异为精准干预提供依据。
ObjectiveObjective To investigate the association between cardiometabolic index(CMI)and hypertension subtypes in elderly Chinese population and provide a scientific evidence for hypertension classification and personalized intervention.MethodsA cross-sectional study was conducted,including 1022 elderly patients(≥60 years old)admitted to Qilu Hospital of Shandong University from January to December 2015.Patients with secondary hypertension and severe complications were excluded.Blood pressure,waist circumference,blood lipid,and other indicators were measured through standardized procedures,Multivariate logistic regression was used to analyze the association between CMI and subtypes,and stratified analysis was conducted based on gender,smoking,age,pulse and metabolic indicators.ResultsCMI was significantly higher in SDH group than in other subtypes(P<0.01).Waist circumference,body mass index and triglycerides were positively correlated with all three types of hypertensions(P<0.05).The multivariate model showed that CMI was an independent risk factor for hypertension subtypes(SDH OR=6.14,IDH OR=4.14,ISH OR=3.28,all P<0.01).Stratified analysis showed that CMI was associated with all subtypes in females(P<0.01),while in males,it was only associated with IDH and SDH.The effect of CMI was stronger in non-smokers(SDH OR=9.56,P<0.001).Hyperglycemia and different concentrations of low-density lipoprotein cholesterol levels aggravate the effect of CMI on SDH.ConclusionsCMI may be an independent risk factor for hypertension subtypes in the elderly.The differences in gender,metabolic status and smoking behavior provide a basis for precise intervention.
作者
贺春伟
彭洁
沈琳
He Chunwei;Peng Jie;Shen Lin(Department of Critical Care Medicine,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Geriatric Medicine&Laboratory of Gerontology and Anti-Aging Research,Qilu Hospital of Shandong University,Jinan 250012,Shandong Province,China)
出处
《中华老年医学杂志》
北大核心
2025年第8期1040-1047,共8页
Chinese Journal of Geriatrics
基金
国家自然科学基金(8180076)。
关键词
心脏代谢指数
高血压
高血压亚型
Cardiometabolic index
Hypertension
Subtype of hypertension
