고혈압을 동반한 당뇨병에서 유병기간에 따른 뇌졸중 위험도
Risk of Stroke according to the Duration of Diabetes Mellitus with Hypertension
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초록
뇌졸중은 사망발생 및 장애를 일으키는 주요 원인 질환이며, 당뇨병은 뇌졸중의 주요 위험인자이다. 당뇨병 환자가운데 뇌졸중을 동반한 환자에서 적정 혈압 관리의 중요성을 알아보고자한다. 제6기 국민건강영양조사 자료를 바탕으로 18세 이상 80 세 미만자 총 16,389명을 대상으로 회귀분석을 통하여 당뇨병유병기간에 따른 혈압조절을 통한 뇌졸중의 위험도를 산정하였다. 당뇨병 유무에 따른 뇌졸중의 유병률은 당뇨병 환자 군에서높았고, 당뇨병의 유병기간이 길어질수록 고혈압과 뇌졸중의위험도는 상승하였으며, 당뇨병과 고혈압에 대한 치료 비율은높았다. 고혈압군에 비해 적정 혈압 유지군(＜140/＜90 mmHg) 에서 뇌졸중 위험비(HR)는 0.57 낮았다. 당뇨병과 고혈압에 대한 치료가 동반됨에도 불구하고 고혈압의 빈도는 상승하였고, 당뇨병 유병기간 5년 이후 뇌졸중의 유병률이 상승함에 따라 이시기의 효과적인 혈압관리가 더욱 중요하다. 당뇨병 환자에서지속적으로 적정 혈압으로 관리함으로써 뇌졸중 위험도를 낮추는 것이 중요하다.
Abstract
Stroke is a major cause of death and disorder, and diabetes mellitus (DM) is a significant risk factor of stroke. This study examined the importance of target blood pressure (＜140/＜90 mmHg) management in patients with DM. Based on the data of the 6th National Health and Nutrition Examination Survey, a total of 16,389 patients aged 18 to under 80 were assessed through regression analysis to estimate the risk of stroke through blood pressure control. The prevalence of stroke according to the presence or absence of DM was higher in the diabetic group, and a longer duration of DM indicated a higher risk of hypertension and stroke. The hazard ratio of stroke was lower in the maintenance group (0.57) of target blood pressure (＜140/＜90 mmHg) compared to the high blood pressure group(＞140/＞90 mmHg). Despite the accompanying treatment for DM and hypertension, the frequency of hypertension increased, and the prevalence of stroke increased after five years of DM. Hence, effective blood pressure management at this time is important. The risk of stroke should be reduced by continuously managing blood pressure in DM.
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