METHODS: This sub-study formed part of the Viborg Screening Program (VISP), a cross-sectorial population-based cardiovascular screening programme targeting 67-year-old Danes. VISP includes screening for peripheral atherosclerosis (lower extremity arterial disease and carotid plaque), abdominal aortic aneurysm, hypertension, diabetes mellitus, and cardiac disease. Self-reported comorbidities, risk factors, and medication use were also collected. Among 4,602 attendees, 4,517 (82.1%) had eligible bilateral and repeated BP measurements. IAD was defined as a systolic BP difference ≥ 10 mmHg. IAD-associated factors (screening results and risk factors) were estimated by logistic regression; proportional coexistence was displayed by Venn diagrams (screening results).
RESULTS: We included 2,220 women (49.2%) and 2,297 men (50.8%). IAD was more predominant in women (26.8%) than men (21.0%) (p < 0.001). This disparity persisted after adjustment [odds ratio (OR) 1.53; 95% confidence interval (CI) 1.32-1.77]. No other association was recorded with the conditions screened for, barring potential hypertension: BP 140-159/90-99 mmHg (OR 1.68, 95% CI 1.44-1.97) and BP ≥ 160/100 mmHg (OR 1.82, 95% CI 1.49-2.23). Overall, IAD and BP ≥ 160/100 mmHg coexistence was 4% in women and 5% in men; for BP ≥ 140/90 mmHg, 13% and 14%, respectively. Among those recording a mean BP ≥ 140/90 mmHg in the higher reading arm, 14.5% of women and 15.3% of men would be misclassified as non-hypertensive compared with the lowest reading arm.
CONCLUSIONS: Female sex was an independent factor of IAD prevalence but not associated with other arterial lesions. Approximately 15% needed reclassification according to BP ≥ 140/90 mmHg when the lower rather than the higher reading arm was used; verifying bilateral BP measurements improved detection of potential hypertension. In future, the predictive value of sex-stratified IAD should be assessed for cardiovascular events and death to verify its potential as a screening tool in population-based cardiovascular screening.
UNASSIGNED: NCT03395509:10/12/2018.
方法:这项子研究是维堡筛查计划(VISP)的一部分,一项针对67岁丹麦人的跨部门人群心血管筛查计划.VISP包括筛查外周动脉粥样硬化(下肢动脉疾病和颈动脉斑块),腹主动脉瘤,高血压,糖尿病,和心脏病。自我报告的合并症,危险因素,还收集了药物使用情况。在4602名与会者中,4,517(82.1%)进行了合格的双边和重复BP测量。IAD定义为收缩压差值≥10mmHg。通过逻辑回归估计IAD相关因素(筛查结果和危险因素);通过维恩图(筛查结果)显示比例共存。
结果:我们包括2,220名女性(49.2%)和2,297名男性(50.8%)。IAD在女性(26.8%)比男性(21.0%)更为明显(p<0.001)。调整后这种差异仍然存在[优势比(OR)1.53;95%置信区间(CI)1.32-1.77]。没有记录与筛选条件的其他关联,除非潜在高血压:BP140-159/90-99mmHg(OR1.68,95%CI1.44-1.97)和BP≥160/100mmHg(OR1.82,95%CI1.49-2.23)。总的来说,IAD和BP≥160/100mmHg共存的女性为4%,男性为5%;对于BP≥140/90mmHg,13%和14%,分别。在较高阅读臂中记录平均BP≥140/90mmHg的人中,与最低阅读臂相比,14.5%的女性和15.3%的男性会被错误分类为非高血压。
结论:女性是IAD患病率的独立因素,但与其他动脉病变无关。当使用较低而不是较高的阅读臂时,大约15%的人需要根据BP≥140/90mmHg进行重新分类;验证双侧BP测量结果可改善对潜在高血压的检测。在未来,应评估性别分层IAD对心血管事件和死亡的预测价值,以验证其作为人群心血管筛查筛查工具的潜力.
■NCT03395509:2018年10月12日。