[1]钱晰彦 汤一帆 梅克文 高春红 范云霞 李婷茹.高血压患者心血管疾病发病风险的Rothman-Keller模型构建[J].心血管病学进展,2025,(6):548.[doi:10.16806/j.cnki.issn.1004-3934.2025.06.016]
　QIAN Xiyan,TANG Yifan,MEI Kewen,et al.The Construction of Rothman-Keller Model for the Cardiovascular Disease Risk in Hypertensive Patients[J].Advances in Cardiovascular Diseases,2025,(6):548.[doi:10.16806/j.cnki.issn.1004-3934.2025.06.016]
点击复制

高血压患者心血管疾病发病风险的Rothman-Keller模型构建()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年6期
页码:
548
栏目:
论著
出版日期:
2025-06-25

文章信息/Info

Title:
The Construction of Rothman-Keller Model for the Cardiovascular Disease Risk in Hypertensive Patients
作者:
钱晰彦1 汤一帆1 梅克文 2 高春红 3 范云霞 2 李婷茹 1
(1.南京医科大学第一附属医院老年心血管科,江苏 南京 210000;2.南京医科大学第一附属医院老年医学科,江苏 南京 210000;3.南京医科大学第一附属医院护理部,江苏 南京 210000)
Author(s):
QIAN Xiyan1; TANG Yifan1; MEI Kewen2; GAO Chunhong3; FAN Yunxia2; LI Tingru1
(1.Department of Geriatric Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210000, Jiangsu,China2.Department of Geriatrics,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210000, Jiangsu,China3.Department of Nursing,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210000, Jiangsu,China)
关键词:
高血压; 心血管疾病; 影响因素; meta分析; Rothman-Keller模型
Keywords:
High blood pressure;  Cardiovascular diseases;  Influencing factors;  Meta-analysis;  Rothman-Keller model
DOI:
10.16806/j.cnki.issn.1004-3934.2025.06.016
摘要:
目的 构建用于评估高血压人群发生心血管疾病（CVD）风险的 Rothman-Keller模型，并在模型的基础上确定疾病风险等级的划分。方法 本研究在PubMed、Embase、Web of Science、CINAHL等数据库中全面检索2022年11月之前公开发表的英文文献，提取被纳入文献的相关数据，采用Revman 5.3.5软件进行meta分析，通过OR值及暴露率等计算出相关参数，建立Rothman-Keller模型，再通过二项分布函数的方法来确定风险等级界限。结果 最终共纳入了60篇文章进行meta分析，共得到11种危险因素，分别为男性、高龄、高胆固醇、低肾小球滤过率、糖尿病、贫血、体能状态差、高血压治疗经历、高血压控制不佳、抑郁、睡眠呼吸暂停。将11项危险因素的二项分布函数随机生成的20 000例数据代入到Rothman-Keller模型中，绘制出了高血压患者发生CVD风险的发病风险曲线，选择0.373 7、0.605 4作为低、中、高危的分界值。结论 本研究构建的高血压患者CVD发病风险的Rothman-Keller模型简单易行，并具有一定的准确性及预测能力，可为临床识别高血压人群中可能发生CVD的高风险患者提供帮助，促进CVD一级预防，具有一定的参考意义。
Abstract:
Objective To construct a Rothman-Keller model for assessing the risk of cardiovascular disease (CVD) in hypertensive populations and to determine the classification of disease risk levels based on the model. Methods This study comprehensively searched PubMed ,Embase,Web of Science,CINAHL,and other databases for publicly available English literature published before November 2021. Relevant data from included articles were extracted,and a meta-analysis was conducted using Revman 5.3.5 software. Relevant parameters were calculated through OR values and exposure rates ,and the Rothman-Keller model was established. The risk level boundaries were determined using the method of binomial distribution functions. Results A total of 60 articles were finally included for Meta-analysis,yielding 11 risk factors: male gender,advanced age,high cholesterol,low glomerular filtration rate,diabetes,anemia,poor physical condition,history of hypertension treatment,poor hypertension control,depression,and sleep apnea. The binomial distribution function of these 11 risk factors randomly generated 20 000 sets of data,which were input into the Rothman-Keller model to plot the incidence risk curve for CVD in hypertensive patients. The values 0.373 7 and 0.605 4 were selected as the boundaries for low,medium,and high risk. Conclusion The Rothman-Keller model constructed in this study for assessing the risk of CVD in hypertensive patients is simple and feasible ,with certain accuracy and predictive ability. It can assist in identifying high-risk patients among hypertensive populations who may develop CVD,promoting primary prevention of CVD,and has certain reference significance

参考文献/References:

[1]Nedkoff L,Briffa T,Zemedikun D,et al.Global trends in atherosclerotic cardiovascular disease[J]. Clin Ther,2023,45(11):1087-1091.

[2]Mills KT,Stefanescu A,He J.The global epidemiology of hypertension[J]. Nat Rev Nephrol,2020,16(4):223-237.

[3]Engelen SE,van der Graaf Y,Stam-Slob MC,et al. Incidence of cardiovascular events and vascular interventions in patients with type 2 diabetes[J]. Int J Cardiol,2017,248:301-307.

[4]吴洵,覃玉,崔岚,等.江苏省居民心血管病高危人群流行病学特征及其影响因素分析[J]. 中华流行病学杂志,2022,43(1):78-84.

[5]Teo KK,Rafiq T. Cardiovascular risk factors and prevention: a perspective from developing countries[J]. Can J Cardiol,2021,37(5):733-743.

[6]赵冬.心血管疾病危险因素的研究:过去、现在和未来[J].中国循环杂志,2021,36(1):1-3.

[7]Rothman K,Keller A.The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx[J].J Chronic Dis,1972,25(12):711-716.

[8]薄小杰,马乐,杨森.循证视角下成年女性压力性尿失禁发病风险的Rothman-Keller模型构建研究[J].中国全科医学,2021,24(30):3893-3899.

[9]Shimamoto K,Fujita T,Ito S,et al. Impact of blood pressure control on cardiovascular events in 26,512 Japanese hypertensive patients: the Japan Hypertension Evaluation with Angiotensin ⅡAntagonist Losartan Therapy (J-HEALTH) study,a prospective nationwide observational study[J]. Hypertens Res, 2008 ,31(3):469-478.

[10]Thomas F,Rudnichi A,Bacri AM,et al. Cardiovascular mortality in hypertensive men according to presence of associated risk factors[J].Hypertension,2001,37(5):1256-1261.

[11]Colafella KMM,Denton KM. Sex-specific differences in hypertension and associated cardiovascular disease[J]. Nat Rev Nephrol,2018,14(3):185-201.

[12]唐敏. 慢性肾脏病合并高血压患者发生心血管疾病以及收缩压控制的相关影响因素分析[J]. 医师在线,2023,13(11):3-7.

[13]Fravel MA,Ernst ME,Webb KL,et al. GFR variability,survival,and cardiovascular events in older adults[J]. Kidney Med,2022,12;5(2):100583.

[14]Kim-Mitsuyama S,Soejima H,Yasuda O,et al. Anemia is an independent risk factor for cardiovascular and renal events in hypertensive outpatients with well-controlled blood pressure: a subgroup analysis of the ATTEMPT-CVD randomized trial[J]. Hypertens Res,2019,42(6):883-891.

[15]Salman LA,Shulman R,Cohen JB. Obstructive sleep apnea,hypertension,and cardiovascular risk: epidemiology,pathophysiology,and management[J].Curr Cardiol Rep,2020,18;22(2):6.

[16]Korostovtseva LS,Sviryaev YV,Zvartau NE,et al. Prognosis and cardiovascular morbidity and mortality in prospective study of hypertensive patients with obstructive sleep apnea syndrome in St Petersburg,Russia[J].Med Sci Monit,2011,17(3):CR146-CR153.

[17]Mefford MT,Goyal P,Howard G,et al. The association of hypertension,hypertension duration,and control with incident heart failure in black and white adults[J]. J Clin Hypertens (Greenwich),2020,22(5):857-866.

[18]Wang M,Wu T,Yu C,et al. Association between blood pressure levels and cardiovascular deaths: a 20-year follow-up study in rural China[J]. BMJ Open,2020,10(2):e035190.

[19]Zhou T,Su J,Tao R,et al. The association between daily total physical activity and risk of cardiovascular disease among hypertensive patients: a 10-year prospective cohort study in China[J]. BMC Public Health,2021,21(1):517.

[20]中华人民共和国国家卫生健康委员会.成人高血压食养指南（2023年版）[J]. 全科医学临床与教育,2023,21(06):484-485+507.

[21]杨淞淳,孙至佳,吕筠,等.心血管疾病风险预测模型研究进展[J].中华心血管病杂志,2022,50(12):1243-1251.

相似文献/References:

[1]白春兰,张军.正五聚蛋白-3:新型心血管病炎性标志物[J].心血管病学进展,2016,(1):87.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.023]
　BAI Chunlan,ZHANG Jun.Pentraxin-3: A Novel Inflammation Biomarker for Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2016,(6):87.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.023]
[2]孙刚,黄冠华,综述.高血压合并心力衰竭的治疗策略[J].心血管病学进展,2016,(2):201.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.027]
　SUN Gang,HUANG Guanhua.Treatment Strategy of Hypertension with Heart Failure[J].Advances in Cardiovascular Diseases,2016,(6):201.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.027]
[3]范贵娟,综述,徐瑞,等.盐敏感性高血压的研究进展[J].心血管病学进展,2016,(4):364.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.010]
　FAN Guijuan,XU Rui.Research Progress of Salt Sensitive Hypertension[J].Advances in Cardiovascular Diseases,2016,(6):364.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.010]
[4]陈源源.钙通道阻滞剂在降压治疗中的应用[J].心血管病学进展,2015,(6):662.[doi:10.3969/j.issn.1004-3934.2015.06.002]
　CHEN Yuanyuan.Application of Calcium Channel Blockers in Hypertension Treatment[J].Advances in Cardiovascular Diseases,2015,(6):662.[doi:10.3969/j.issn.1004-3934.2015.06.002]
[5]张瑞 毛露 孙硕 Dirk Hermann 陈艾东.内皮素-1干预成为高血压治疗新靶点的展望[J].心血管病学进展,2019,(7):969.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.000]
　ZHANG Rui MAO LuSUN ShuoDIRK Hermann CHEN Aidong.The Prospect of Endothelin-1 Intervention as A New Target for the Treatment of Hypertension[J].Advances in Cardiovascular Diseases,2019,(6):969.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.000]
[6]张毅,柳志红.动态血压监测在高血压中的应用现状与问题[J].心血管病学进展,2019,(6):848.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.003]
　ZHANG Yi,LIU Zhihong.Current status and nsolved Pproblems of Ambulatory Blood Pressure Monitoring for the Management of Hypertension[J].Advances in Cardiovascular Diseases,2019,(6):848.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.003]
[7]任茂佳,贺文帅,张琪,等.围绝经期对心血管疾病相关危险因素的影响[J].心血管病学进展,2019,(6):911.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.018]
　REN Maojia,HE Wenshuai,ZHANG Qi,et al.Effects of Perimenopause on Cardiovascular Risk Factors[J].Advances in Cardiovascular Diseases,2019,(6):911.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.018]
[8]黄秋瑾 胡蓉.高血压合并糖尿病患者血压控制率和控制目标的探讨[J].心血管病学进展,2019,(7):973.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.002]
　HUANG QiujinHU Rong.Discussion on Blood Pressure Control Rate and Control Target in Patients with Hypertension Complicated with Diabetes[J].Advances in Cardiovascular Diseases,2019,(6):973.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.002]
[9]张旭明 王曦.高血压对认知功能的影响[J].心血管病学进展,2019,(7):977.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.003]
　ZHANG Xuming,WANG Xi.The Relationship Between Hypertension and Cognitive Function[J].Advances in Cardiovascular Diseases,2019,(6):977.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.003]
[10]尹琳 黄从新.JP2蛋白和心血管疾病的研究进展[J].心血管病学进展,2019,(7):1004.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.010]
　YIN Lin HUANG Congxin.Research Progress of JP2 Protein and Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2019,(6):1004.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.010]
[11]王帅 高睿媛 刘飞 夏云龙.具有潜在VEGF抑制剂适应证的甲状腺癌及肝癌患者心血管疾病分布的横断面调查研究[J].心血管病学进展,2021,(11):1040.[doi:10.16806/j.cnki.issn.1004-3934.2021.11.000]
　WANG ShuaiGAO Ruiyuan,LIU Fei,XIA Yunlong.Distribution of Cardiovascular Comorbidities in Thyroid Cancer and Hepatocellular Carcinoma Patients with Potential Indications for VEGF Inhibitors[J].Advances in Cardiovascular Diseases,2021,(6):1040.[doi:10.16806/j.cnki.issn.1004-3934.2021.11.000]
[12]杨双 唐艳红.P2X3受体在心血管疾病中的研究进展[J].心血管病学进展,2022,(2):117.[doi:10.16806/j.cnki.issn.1004-3934.2022.02.006]
　YANG Shuang,TANG Yanhong.P2X3 Receptor in Cardiovascular Diseases[J].Advances in Cardiovascular Diseases,2022,(6):117.[doi:10.16806/j.cnki.issn.1004-3934.2022.02.006]
[13]曲梦蕊 赵卉.肺功能下降与高血压的相关性研究进展[J].心血管病学进展,2022,(8):719.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.013]
　QU Mengrui,ZHAO Hui.The Correlation Between Pulmonary Function Decline and Hypertension[J].Advances in Cardiovascular Diseases,2022,(6):719.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.013]
[14]冯炜琦 陈颖慧 丁晓维 赵鹏军 于昱.多巴胺受体在心血管疾病中的作用及其分子机制研究进展[J].心血管病学进展,2022,(8):726.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.015]
　FENG Weiqi,CHEN Yinghui,DING Xiaowei,et al.Function of Dopamine Receptors in Cardiovascular Diseases[J].Advances in Cardiovascular Diseases,2022,(6):726.[doi:10.16806/j.cnki.issn.1004-3934.2022.08.015]
[15]徐辽 刘育.Kv7通道与心血管疾病[J].心血管病学进展,2022,(12):1127.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.016]
　XU Liao,LIU Yu.Kv7 Channels and Cardiovascular Diseases[J].Advances in Cardiovascular Diseases,2022,(6):1127.[doi:10.16806/j.cnki.issn.1004-3934.2022.12.016]
[16]刘张弛 杨波.瞬时受体电位香草酸亚型4在心血管疾病中的研究进展[J].心血管病学进展,2023,(9):777.[doi:10.16806/j.cnki.issn.1004-3934.2023.09.000]
　LIU Zhangchi,YANG Bo?/html>.Transient Receptor Potential Vanilloid 4 in Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2023,(6):777.[doi:10.16806/j.cnki.issn.1004-3934.2023.09.000]

更新日期/Last Update: 2025-07-31