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Article(id=1324077876475200275, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509445, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758729600000, receivedDateStr=2025-09-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614365929, onlineDateStr=2026-11-02, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614365929, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614365929, creator=13701087609, updateTime=1793614365929, updator=13701087609, issue=Issue{id=1324077716676424398, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614327830, creator='13701087609', updateTime=1793614418028, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078095132655884, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078095132655885, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=788, endPage=795, ext={EN=ArticleExt(id=1324077877964178196, articleId=1324077876475200275, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Prospective cohort study on LDL-C levels and risks of all-cause and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the impact of low-density lipoprotein cholesterol (LDL-C) levels on all-cause mortality and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities.

Method

Univariate analyses were performed using the χ2 test, and Cox proportional hazards regression models were used to analyze the impact of LDL-C levels on the all-cause and cardio-cerebrovascular mortality risks of patients with hypertension and its comorbidities.

Results

Multivariable Cox regression analysis showed that among patients with hypertension, compared with the first quartile group (Q1)of LDL-C, the risk of all-cause mortality increased by 75% in the third quartile group (Q3) and by 165% in the fourth quartile group (Q4), and the risk of cardio-cerebrovascular death increased by 96.4% in the Q4 group. Among the patients with comorbidities, the all-cause mortality risks of groups Q2, Q3, and Q4 were 1.601 times, 2.082 times, and 2.874 times that of group Q1, respectively. The cardio-cerebrovascular mortality risk of group Q4 was 2.592 times that of group Q1. The restricted cubic spline (RCS) model indicated that the LDL-C level was linearly correlated with the risk of all-cause and cardio-cerebrovascular death in patients with hypertension and its comorbidities. Among them, for patients with hypertension, the risk significantly increased when LDL-C exceeded 2.713 mmol/L (for all-cause mortality) and 2.650 mmol/L (for cardio-cerebrovascular mortality). For patients with comorbidities, the risk increased when LDL-C was higher than 2.016 mmol/L (for all-cause mortality) and 2.020 mmol/L (for cardio-cerebrovascular mortality).

Conclusion

Serum LDL-C levels are an independent risk factor for all-cause and cardio-cerebrovascular deaths in patients with hypertension and its comorbidities.This study reveals the dose-response relationship between LDL-C levels and mortality, providing an important scientific basis for more stringent lipid-lowering intervention strategies in clinical practice.

, authors=Quan-jing LI1, Yi-ying YANG1, Fu-yan ZHANG2, Xiao-xue LI3, Li-hua YIN3, He-yan WANG1, Tao LIU4, authorsList=Quan-jing LI, Yi-ying YANG, Fu-yan ZHANG, Xiao-xue LI, Li-hua YIN, He-yan WANG, Tao LIU, authorCompany=null, correspAuthors=Tao LIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077879012754203, articleId=1324077876475200275, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=低密度脂蛋白胆固醇水平对高血压及其共病患者的全因死亡与心脑血管死亡风险的前瞻性队列研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

分析低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)水平对高血压及其共病患者全因死亡和心脑血管死亡的影响。

方法

本研究利用χ2检验进行单因素分析，运用 COX 比例风险回归模型来分析LDL-C水平对高血压及其共病患者的全因与心脑血管死亡风险的影响。

结果

多因素 COX 回归分析显示：高血压人群中，与LDL-C 第一分位组（Q1）相比，第三分位组（Q3）、第四分位组（Q4）全因死亡风险分别增加 75%、165%，Q4 组心脑血管死亡风险增加 96.4%；共病人群中，Q2、Q3和Q4 组全因死亡风险分别为 Q1 组的 1.601 、2.082 和2.874 倍，Q4 组心脑血管死亡风险为 Q1 组的 2.592 倍。限制性立方样条模型提示，LDL-C 水平与高血压及共病患者全因死亡、心脑血管死亡风险均呈线性相关。其中，高血压患者 LDL-C 超过 2.713 mmol/L（全因死亡）、2.650 mmol/L（心脑血管死亡）时风险显著升高；共病患者 LDL-C 高于 2.016 mmol/L（全因死亡）、2.020 mmol/L（心脑血管死亡）时风险升高。

结论

血清LDL-C水平是高血压及其共病患者全因死亡和心脑血管死亡的独立危险因素，揭示了LDL-C水平与死亡的剂量反应关系，为临床上更严格的降脂干预策略提供了重要的科学依据。

, authors=李权静1, 杨奕樱1, 张福艳2, 李小雪3, 尹丽华3, 王和艳1, 刘涛4, authorsList=李权静, 杨奕樱, 张福艳, 李小雪, 尹丽华, 王和艳, 刘涛, authorCompany=null, correspAuthors=刘涛, authorNote=

李权静（2000—），女，硕士在读，研究方向：慢性非传染性疾病预防与控制

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刘涛，E-mail:
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李权静（2000—），女，硕士在读，研究方向：慢性非传染性疾病预防与控制

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Association of Low-Density lipoprotein cholesterol levels with more than 20-Year risk of cardiovascular and All-Cause mortality in the general population[J].Journal of the American Heart Association, 2022, 11(15): e023690., articleTitle=Association of Low-Density lipoprotein cholesterol levels with more than 20-Year risk of cardiovascular and All-Cause mortality in the general population, refAbstract=null), Reference(id=1324077889477542781, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, doi=null, pmid=null, pmcid=null, year=2019, volume=139, issue=25, pageStart=e1082, pageEnd=e1143, url=null, language=null, rfNumber=[24], rfOrder=29, authorNames=Grundy SM, Stone NJ, Bailey AL, journalName=Circulation, refType=null, unstructuredReference=Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American college of cardiology/American heart association task force on clinical practice guidelines[J]. Circulation, 2019, 139(25): e1082-e1143., articleTitle=2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American college of cardiology/American heart association task force on clinical practice guidelines, refAbstract=null), Reference(id=1324077889569817470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, doi=null, pmid=null, pmcid=null, year=2015, volume=15, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[25], rfOrder=30, authorNames=Lee SH, Park MS, Park BH, journalName=BioMed Research International, refType=null, unstructuredReference=Lee SH, Park MS, Park BH, et al. Prognostic implications of serum lipid metabolism over time during sepsis[J]. 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注：对高血压患者及高血压共病患者的调整变量与前文COX回归分析中模型3一致；HR为hazard ratio。

, figureFileSmall=RS952QDB0LTRodtdDn1qwQ==, figureFileBig=ViFHJrASgV6oDTI8hYPBsw==, tableContent=null), ArticleFig(id=1324077884524069718, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=EN, label=Figure 3, caption=Sensitivity analysis, figureFileSmall=eGL4CGKPkVb84O4Q+QJHcQ==, figureFileBig=AG4Ld04l+x3tgVm/1nwlDQ==, tableContent=null), ArticleFig(id=1324077884591178583, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=CN, label=图3, caption=敏感性分析

注：高血压患者和高血压共病患者的调整变量与前文COX回归分析中模型3一致；HR为hazard ratio；A为剔除患恶性肿瘤的患者；B为剔除年龄大于85岁人群。

, figureFileSmall=eGL4CGKPkVb84O4Q+QJHcQ==, figureFileBig=AG4Ld04l+x3tgVm/1nwlDQ==, tableContent=null), ArticleFig(id=1324077884658287448, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=EN, label=Table 1, caption=

Baseline characteristics of patients with hypertension and its comorbidities ［n（%），M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征高血压人群高血压共病患者
调查人数LDL-C 水平(mmol/L)P值调查人数LDL-C 水平(mmol/L)P值
≤2
(n=454)		2～2.63
(n=755)		2.64～3.34
(n=608)		≥3.35
(n=609)		≤2
（n=332)		2～2.63
(n=538)		2.64～3.34
(n=377)		≥3.35
(n=322)
年龄(岁)0.9000.508
<601 554289(18.6)484(31.1)384(24.7)397(25.5)998200(20)347(34.8)240(24)211(21.1)
≥60872165(18.9)271(31.1)224(25.7)212(24.3)571132(23.1)191(33.5)137(24)111(19.4)
性别0.1540.227
男1 284252(19.6)415(32.3)303(23.6)314(24.5)812183(22.5)285(35.1)180(22.2)164(20.2)
女1 142202(17.7)340(29.8)305(26.7)295(25.8)757149(19.7)253(33.4)197(26)158(20.9)
民族0.0240.128
少数民族913176(19.3)303(33.2)236(25.8)198(21.7)593121(20.4)219(36.9)147(24.8)106(17.9)
汉族1 513278(18.4)452(29.9)372(24.6)411(27.2)976211(21.6)319(32.7)230(23.6)216(22.1)
教育水平0.2040.145
初中及以下2 170416(19.2)678(31.2)540(24.9)536(24.7)1 372299(21.8)474(34.5)328(23.9)271(19.8)
高中/中专17928(15.6)48(26.8)53(29.6)50(27.9)13625(18.4)38(27.9)36(26.5)37(27.2)
大专及以上7710(13.0)29(37.7)15(19.5)23(29.9)618(13.1)26(42.6)13(21.3)14(23)
BMIa<0.001<0.001
轻体重9123(25.3)37(40.7)18(19.8)13(14.3)4415(34.11)22(50)6(13.6)1(2.3)
正常1 231246(20.0)429(34.8)307(24.9)249(20.2)699165(23.6)281(40.2)152(21.7)101(14.4)
超重783129(16.5)220(28.1)193(24.6)241(30.8)579103(17.8)176(30.4)147(25.4)153(26.4)
肥胖31353(16.9)64(20.4)90(28.8)106(33.9)24147(19.5)55(22.8)72(29.9)67(27.8)
有害饮酒0.3610.335
否2 335433(18.5)734(31.4)583(25.0)585(25.1)1 517316(20.8)524(34.5)366(24.1)311(20.5)
是9121(23.1)21(23.1)25(27.5)24(26.4)5216(30.8)14(26.9)11(21.2)11(21.2)
目前吸烟0.2790.248
否1 642298(18.1)499(30.4)417(25.4)428(26.1)1 074215(20)365(34)270(25.1)224(20.9)
是784156(19.9)256(32.7)191(24.4)181(23.1)495117(23.6)173(34.9)107(21.6)98(19.8)
蔬菜水果摄入a≥500g/d0.6410.141
否753150(19.9)237(31.5)185(24.6)181(24.0)497112(22.5)175(35.2)125(25.2)85(17.1)
是1 667301(18.1)516(31.0)422(25.3)428(25.7)1 070219(20.5)363(33.9)251(23.5)237(22.1)
油摄入a>25g/d<0.0010.003
否698109(15.6)206(29.5)166(23.8)217(31.1)41672(17.3)138(33.2)97(23.3)109(26.2)
是1 705340(19.9)540(31.7)439(25.7)386(22.6)1 137257(22.6)395(34.7)278(24.5)207(18.2)
盐摄入>5g/d<0.001<0.001
否38463(16.4)94(24.5)84(21.9)143(37.2)22641(18.1)62(27.4)46(20.4)77(34.1)
是2 042391(19.1)661(32.4)524(25.7)466(22.8)1 343291(21.7)476(35.4)331(24.6)245(18.2)
静态时间（h）0.0070.052
<41 087209(19.2)364(33.5)276(25.4)238(21.9)700146(20.9)261(37.3)168(24)125(17.9)
≥41 339245（18.3)391(29.2)332(24.8)371(27.7)869186(21.4)277(31.9)209(24.1)197(22.7)
睡眠时间（h/d）0.5240.932
<742576(17.9)122(28.7)113(26.6)114(26.8)28460(21.1)93(32.7)71(25)60(21.1)
≥72 001378(18.9)633(31.6)495(24.7)495(24.7)1 285271(21.2)445(34.6)306(23.8)262(20.4)
CVD0.530
否2 402451(18.8)745(31.0)604(25.1)602(25.1)———
是243(12.5)10(41.7)4(16.7)7(29.2)———
糖尿病0.157
否2 057396(19.3)643(31.3)517(25.1)501(24.4)———
是36958(15.7)112(30.4)91(24.7)108(29.3)———
COPDa0.001
否2 368433(18.3)734(31.0)603(25.5)598(25.3)———
是5720(35.1)21(36.8)5(8.8)11(19.3)———
高甘油三酯血症a<0.001
否1 770308(17.4)611(34.5)470(26.6)381(21.5)———
是647145(22.4)136(21.0)138(21.3)228(35.2)———
低高密度脂蛋白血症a<0.001
否1 384244(17.6)275(19.9)336(24.3)529(38.2)———
是1 033207(20)476(46.1)271(26.2)79(7.6)———
服用降脂药物0.6040.694
否2379443(18.6)742(31.2)594(25.0)600(25.2)1 522321(21.1)525(34.5)363(23.9)313(20.6)
是4711(23.4)13(27.7)14(29.8)9(19.1)4711(23.4)13(27.7)14(29.8)9(19.1)
抑郁a0.715
否2 202411(18.7)685(31.1)554(25.2)552(25.1)———
是17235(20.3)50(29.1)39(22.7)48(27.9)———
收缩压2 426151(142, 166)151(141, 163)150(140, 162)147(138, 160)<0.0011 569152(143, 167)152(143, 166)150(141, 163)147(139, 160)<0.001
舒张压2 42691(85,98)91(84,98)91(86，98）90（83，98）0.1841 56991(84,98)91(85,98)92(87,99)91(83,99)0.167
), ArticleFig(id=1324077884767339353, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=CN, label=表1, caption=

高血压患者及高血压共病患者的基线特征［n（%），M（P25，P75）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征高血压人群高血压共病患者
调查人数LDL-C 水平(mmol/L)P值调查人数LDL-C 水平(mmol/L)P值
≤2
(n=454)		2～2.63
(n=755)		2.64～3.34
(n=608)		≥3.35
(n=609)		≤2
（n=332)		2～2.63
(n=538)		2.64～3.34
(n=377)		≥3.35
(n=322)
年龄(岁)0.9000.508
<601 554289(18.6)484(31.1)384(24.7)397(25.5)998200(20)347(34.8)240(24)211(21.1)
≥60872165(18.9)271(31.1)224(25.7)212(24.3)571132(23.1)191(33.5)137(24)111(19.4)
性别0.1540.227
男1 284252(19.6)415(32.3)303(23.6)314(24.5)812183(22.5)285(35.1)180(22.2)164(20.2)
女1 142202(17.7)340(29.8)305(26.7)295(25.8)757149(19.7)253(33.4)197(26)158(20.9)
民族0.0240.128
少数民族913176(19.3)303(33.2)236(25.8)198(21.7)593121(20.4)219(36.9)147(24.8)106(17.9)
汉族1 513278(18.4)452(29.9)372(24.6)411(27.2)976211(21.6)319(32.7)230(23.6)216(22.1)
教育水平0.2040.145
初中及以下2 170416(19.2)678(31.2)540(24.9)536(24.7)1 372299(21.8)474(34.5)328(23.9)271(19.8)
高中/中专17928(15.6)48(26.8)53(29.6)50(27.9)13625(18.4)38(27.9)36(26.5)37(27.2)
大专及以上7710(13.0)29(37.7)15(19.5)23(29.9)618(13.1)26(42.6)13(21.3)14(23)
BMIa<0.001<0.001
轻体重9123(25.3)37(40.7)18(19.8)13(14.3)4415(34.11)22(50)6(13.6)1(2.3)
正常1 231246(20.0)429(34.8)307(24.9)249(20.2)699165(23.6)281(40.2)152(21.7)101(14.4)
超重783129(16.5)220(28.1)193(24.6)241(30.8)579103(17.8)176(30.4)147(25.4)153(26.4)
肥胖31353(16.9)64(20.4)90(28.8)106(33.9)24147(19.5)55(22.8)72(29.9)67(27.8)
有害饮酒0.3610.335
否2 335433(18.5)734(31.4)583(25.0)585(25.1)1 517316(20.8)524(34.5)366(24.1)311(20.5)
是9121(23.1)21(23.1)25(27.5)24(26.4)5216(30.8)14(26.9)11(21.2)11(21.2)
目前吸烟0.2790.248
否1 642298(18.1)499(30.4)417(25.4)428(26.1)1 074215(20)365(34)270(25.1)224(20.9)
是784156(19.9)256(32.7)191(24.4)181(23.1)495117(23.6)173(34.9)107(21.6)98(19.8)
蔬菜水果摄入a≥500g/d0.6410.141
否753150(19.9)237(31.5)185(24.6)181(24.0)497112(22.5)175(35.2)125(25.2)85(17.1)
是1 667301(18.1)516(31.0)422(25.3)428(25.7)1 070219(20.5)363(33.9)251(23.5)237(22.1)
油摄入a>25g/d<0.0010.003
否698109(15.6)206(29.5)166(23.8)217(31.1)41672(17.3)138(33.2)97(23.3)109(26.2)
是1 705340(19.9)540(31.7)439(25.7)386(22.6)1 137257(22.6)395(34.7)278(24.5)207(18.2)
盐摄入>5g/d<0.001<0.001
否38463(16.4)94(24.5)84(21.9)143(37.2)22641(18.1)62(27.4)46(20.4)77(34.1)
是2 042391(19.1)661(32.4)524(25.7)466(22.8)1 343291(21.7)476(35.4)331(24.6)245(18.2)
静态时间（h）0.0070.052
<41 087209(19.2)364(33.5)276(25.4)238(21.9)700146(20.9)261(37.3)168(24)125(17.9)
≥41 339245（18.3)391(29.2)332(24.8)371(27.7)869186(21.4)277(31.9)209(24.1)197(22.7)
睡眠时间（h/d）0.5240.932
<742576(17.9)122(28.7)113(26.6)114(26.8)28460(21.1)93(32.7)71(25)60(21.1)
≥72 001378(18.9)633(31.6)495(24.7)495(24.7)1 285271(21.2)445(34.6)306(23.8)262(20.4)
CVD0.530
否2 402451(18.8)745(31.0)604(25.1)602(25.1)———
是243(12.5)10(41.7)4(16.7)7(29.2)———
糖尿病0.157
否2 057396(19.3)643(31.3)517(25.1)501(24.4)———
是36958(15.7)112(30.4)91(24.7)108(29.3)———
COPDa0.001
否2 368433(18.3)734(31.0)603(25.5)598(25.3)———
是5720(35.1)21(36.8)5(8.8)11(19.3)———
高甘油三酯血症a<0.001
否1 770308(17.4)611(34.5)470(26.6)381(21.5)———
是647145(22.4)136(21.0)138(21.3)228(35.2)———
低高密度脂蛋白血症a<0.001
否1 384244(17.6)275(19.9)336(24.3)529(38.2)———
是1 033207(20)476(46.1)271(26.2)79(7.6)———
服用降脂药物0.6040.694
否2379443(18.6)742(31.2)594(25.0)600(25.2)1 522321(21.1)525(34.5)363(23.9)313(20.6)
是4711(23.4)13(27.7)14(29.8)9(19.1)4711(23.4)13(27.7)14(29.8)9(19.1)
抑郁a0.715
否2 202411(18.7)685(31.1)554(25.2)552(25.1)———
是17235(20.3)50(29.1)39(22.7)48(27.9)———
收缩压2 426151(142, 166)151(141, 163)150(140, 162)147(138, 160)<0.0011 569152(143, 167)152(143, 166)150(141, 163)147(139, 160)<0.001
舒张压2 42691(85,98)91(84,98)91(86，98）90（83，98）0.1841 56991(84,98)91(85,98)92(87,99)91(83,99)0.167
), ArticleFig(id=1324077884868002650, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=EN, label=Table 2, caption=

Hazard ratios and 95% confidence intervals for the associations between LDL-C levels and risks of all-cause and cardio-cerebrovascular mortality among patients with hypertension

, figureFileSmall=null, figureFileBig=null, tableContent=
变量死亡人数死亡密度HR(95%CI)
模型1P值模型2P值模型3P值
全因死亡28710.23
LDL-C水平分组(mmol/L)28710.231.106(1.010～1.210)0.0301.121(1.026～1.224)0.0111.260(1.134～1.399)<0.001
Q1(<2)407.35111
Q2(2～2.63)9210.371.453(0.999～2.114)0.0501.521(1.045～2.213)0.0281.483(0.988～2.226)0.057
Q3(2.64～3.34)7510.721.524(1.035～2.245)0.0331.600(1.086～2.358)0.0181.750(1.152～2.656)0.009
Q4(≥3.35)8011.851.740(1.185～2.557)0.0051.902(1.293～2.798)0.0012.650(1.736～4.045)<0.001
P趋势值0.0080.002<0.001
心脑血管死亡1324.70
LDL-C水平分组(mmol/L)1324.701.011(0.879～1.163)0.8751.027(0.897～1.175)0.7041.173(1.001～1.374)0.049
Q1(<2)224.02111
Q2(2～2.63)444.961.301(0.774～2.189)0.3211.390(0.826～2.341)0.2151.326(0.758～2.322)0.323
Q3(2.64～3.34)365.141.371(0.800～2.350)0.2501.434(0.836～2.461)0.1901.568(0.884～2.783)0.124
Q4(≥3.35)304.441.223(0.699～2.141)0.4811.333(0.760～2.338)0.3161.964(1.065～3.621)0.031
P趋势值0.5270.3520.023
), ArticleFig(id=1324077884930917211, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=CN, label=表2, caption=

LDL-C水平对高血压患者的全因死亡与心脑血管死亡风险比和 95% 置信区间

, figureFileSmall=null, figureFileBig=null, tableContent=
变量死亡人数死亡密度HR(95%CI)
模型1P值模型2P值模型3P值
全因死亡28710.23
LDL-C水平分组(mmol/L)28710.231.106(1.010～1.210)0.0301.121(1.026～1.224)0.0111.260(1.134～1.399)<0.001
Q1(<2)407.35111
Q2(2～2.63)9210.371.453(0.999～2.114)0.0501.521(1.045～2.213)0.0281.483(0.988～2.226)0.057
Q3(2.64～3.34)7510.721.524(1.035～2.245)0.0331.600(1.086～2.358)0.0181.750(1.152～2.656)0.009
Q4(≥3.35)8011.851.740(1.185～2.557)0.0051.902(1.293～2.798)0.0012.650(1.736～4.045)<0.001
P趋势值0.0080.002<0.001
心脑血管死亡1324.70
LDL-C水平分组(mmol/L)1324.701.011(0.879～1.163)0.8751.027(0.897～1.175)0.7041.173(1.001～1.374)0.049
Q1(<2)224.02111
Q2(2～2.63)444.961.301(0.774～2.189)0.3211.390(0.826～2.341)0.2151.326(0.758～2.322)0.323
Q3(2.64～3.34)365.141.371(0.800～2.350)0.2501.434(0.836～2.461)0.1901.568(0.884～2.783)0.124
Q4(≥3.35)304.441.223(0.699～2.141)0.4811.333(0.760～2.338)0.3161.964(1.065～3.621)0.031
P趋势值0.5270.3520.023
), ArticleFig(id=1324077885014803292, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=EN, label=Table 3, caption=

Hazard ratios and 95% confidence intervals for the association between LDL-C levels and the risks of all-cause and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities

, figureFileSmall=null, figureFileBig=null, tableContent=
变量死亡人数死亡密度HR(95%CI)
模型1P值模型2P值模型3P值
全因死亡1759.46
LDL-C水平分组(mmol/L)1759.461.101(0.982～1.236)0.1001.123(1.005～1.255)0.0411.272(1.127～1.435)<0.001
Q1(<2)287.00111
Q2(2～2.63)6510.131.511(0.965～2.367)0.0711.669(1.064～2.618)0.0261.601(1.012～2.534)0.044
Q3(2.64～3.34)4510.161.537(0.954～2.477)0.0771.718(1.063～2.774)0.0272.082(1.278～3.390)0.003
Q4(≥3.35)3710.211.622(0.985～2.669)0.0571.876(1.137～3.097)0.0142.874(1.700～4.858)<0.001
P趋势值0.0750.019<0.001
心脑血管死亡894.81
LDL-C水平分组(mmol/L)894.811.041(0.881～1.229)0.6401.066(0.909～1.249)0.4311.233(1.038～1.464)0.017
Q1(<2)174.32111
Q2(2～2.63)345.501.353(0.747～2.452)0.3181.562(0.861～2.835)0.1431.396(0.757～2.573)0.285
Q3(2.64～3.34)204.731.173(0.608～2.265)0.6331.339(0.691～2.592)0.3871.517(0.776～2.965)0.223
Q4(≥3.35)185.171.322(0.673～2.600)0.4181.568(0.795～3.095)0.1942.592(1.265～5.314)0.009
P趋势值0.5500.2970.013
), ArticleFig(id=1324077885107077981, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077876475200275, language=CN, label=表3, caption=

LDL-C 水平对高血压共病患者的全因死亡与心脑血管死亡风险比和95%置信区间

, figureFileSmall=null, figureFileBig=null, tableContent=
变量死亡人数死亡密度HR(95%CI)
模型1P值模型2P值模型3P值
全因死亡1759.46
LDL-C水平分组(mmol/L)1759.461.101(0.982～1.236)0.1001.123(1.005～1.255)0.0411.272(1.127～1.435)<0.001
Q1(<2)287.00111
Q2(2～2.63)6510.131.511(0.965～2.367)0.0711.669(1.064～2.618)0.0261.601(1.012～2.534)0.044
Q3(2.64～3.34)4510.161.537(0.954～2.477)0.0771.718(1.063～2.774)0.0272.082(1.278～3.390)0.003
Q4(≥3.35)3710.211.622(0.985～2.669)0.0571.876(1.137～3.097)0.0142.874(1.700～4.858)<0.001
P趋势值0.0750.019<0.001
心脑血管死亡894.81
LDL-C水平分组(mmol/L)894.811.041(0.881～1.229)0.6401.066(0.909～1.249)0.4311.233(1.038～1.464)0.017
Q1(<2)174.32111
Q2(2～2.63)345.501.353(0.747～2.452)0.3181.562(0.861～2.835)0.1431.396(0.757～2.573)0.285
Q3(2.64～3.34)204.731.173(0.608～2.265)0.6331.339(0.691～2.592)0.3871.517(0.776～2.965)0.223
Q4(≥3.35)185.171.322(0.673～2.600)0.4181.568(0.795～3.095)0.1942.592(1.265～5.314)0.009
P趋势值0.5500.2970.013
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低密度脂蛋白胆固醇水平对高血压及其共病患者的全因死亡与心脑血管死亡风险的前瞻性队列研究
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李权静 1 , 杨奕樱 1 , 张福艳 2 , 李小雪 3 , 尹丽华 3 , 王和艳 1 , 刘涛 4
现代预防医学 | 流行病与统计方法 2026,53(5): 788-795
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现代预防医学 |流行病与统计方法 2026 , 53 (5) : 788 -795
低密度脂蛋白胆固醇水平对高血压及其共病患者的全因死亡与心脑血管死亡风险的前瞻性队列研究
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李权静（2000—），女，硕士在读，研究方向：慢性非传染性疾病预防与控制

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李权静1, 杨奕樱1, 张福艳2, 李小雪3, 尹丽华3, 王和艳1, 刘涛4
作者信息
  • 1.贵州中医药大学基础医学院，贵州 贵阳 550025
  • 2.铜仁职业技术大学护理学院
  • 3.贵州医科大学公共卫生与健康学院
  • 4.贵州省疾病预防控制中心慢性病防治研究所，贵州 贵阳 550004
通讯作者:
刘涛，E-mail:
作者简介:

李权静（2000—），女，硕士在读，研究方向：慢性非传染性疾病预防与控制

Prospective cohort study on LDL-C levels and risks of all-cause and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities
Quan-jing LI1, Yi-ying YANG1, Fu-yan ZHANG2, Xiao-xue LI3, Li-hua YIN3, He-yan WANG1, Tao LIU4
Affiliations
  • School of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550025, China
出版时间: 2026-03-10 doi: 10.20043/j.cnki.MPM.202509445
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摘要
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目的

分析低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)水平对高血压及其共病患者全因死亡和心脑血管死亡的影响。

方法

本研究利用χ2检验进行单因素分析，运用 COX 比例风险回归模型来分析LDL-C水平对高血压及其共病患者的全因与心脑血管死亡风险的影响。

结果

多因素 COX 回归分析显示：高血压人群中，与LDL-C 第一分位组（Q1）相比，第三分位组（Q3）、第四分位组（Q4）全因死亡风险分别增加 75%、165%，Q4 组心脑血管死亡风险增加 96.4%；共病人群中，Q2、Q3和Q4 组全因死亡风险分别为 Q1 组的 1.601 、2.082 和2.874 倍，Q4 组心脑血管死亡风险为 Q1 组的 2.592 倍。限制性立方样条模型提示，LDL-C 水平与高血压及共病患者全因死亡、心脑血管死亡风险均呈线性相关。其中，高血压患者 LDL-C 超过 2.713 mmol/L（全因死亡）、2.650 mmol/L（心脑血管死亡）时风险显著升高；共病患者 LDL-C 高于 2.016 mmol/L（全因死亡）、2.020 mmol/L（心脑血管死亡）时风险升高。

结论

血清LDL-C水平是高血压及其共病患者全因死亡和心脑血管死亡的独立危险因素，揭示了LDL-C水平与死亡的剂量反应关系，为临床上更严格的降脂干预策略提供了重要的科学依据。

高血压  /  高血压共病  /  低密度脂蛋白胆固醇  /  死亡风险  /  心脑血管死亡
Objective

To analyze the impact of low-density lipoprotein cholesterol (LDL-C) levels on all-cause mortality and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities.

Method

Univariate analyses were performed using the χ2 test, and Cox proportional hazards regression models were used to analyze the impact of LDL-C levels on the all-cause and cardio-cerebrovascular mortality risks of patients with hypertension and its comorbidities.

Results

Multivariable Cox regression analysis showed that among patients with hypertension, compared with the first quartile group (Q1)of LDL-C, the risk of all-cause mortality increased by 75% in the third quartile group (Q3) and by 165% in the fourth quartile group (Q4), and the risk of cardio-cerebrovascular death increased by 96.4% in the Q4 group. Among the patients with comorbidities, the all-cause mortality risks of groups Q2, Q3, and Q4 were 1.601 times, 2.082 times, and 2.874 times that of group Q1, respectively. The cardio-cerebrovascular mortality risk of group Q4 was 2.592 times that of group Q1. The restricted cubic spline (RCS) model indicated that the LDL-C level was linearly correlated with the risk of all-cause and cardio-cerebrovascular death in patients with hypertension and its comorbidities. Among them, for patients with hypertension, the risk significantly increased when LDL-C exceeded 2.713 mmol/L (for all-cause mortality) and 2.650 mmol/L (for cardio-cerebrovascular mortality). For patients with comorbidities, the risk increased when LDL-C was higher than 2.016 mmol/L (for all-cause mortality) and 2.020 mmol/L (for cardio-cerebrovascular mortality).

Conclusion

Serum LDL-C levels are an independent risk factor for all-cause and cardio-cerebrovascular deaths in patients with hypertension and its comorbidities.This study reveals the dose-response relationship between LDL-C levels and mortality, providing an important scientific basis for more stringent lipid-lowering intervention strategies in clinical practice.

Hypertension  /  Hypertension comorbidity  /  Low-density lipoprotein cholesterol  /  Risk of mortality  /  Cardio-cerebrovascular mortality
李权静, 杨奕樱, 张福艳, 李小雪, 尹丽华, 王和艳, 刘涛. 低密度脂蛋白胆固醇水平对高血压及其共病患者的全因死亡与心脑血管死亡风险的前瞻性队列研究. 现代预防医学, 2026 , 53 (5) : 788 -795 . DOI: 10.20043/j.cnki.MPM.202509445
Quan-jing LI, Yi-ying YANG, Fu-yan ZHANG, Xiao-xue LI, Li-hua YIN, He-yan WANG, Tao LIU. Prospective cohort study on LDL-C levels and risks of all-cause and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities[J]. Modern Preventive Medicine, 2026 , 53 (5) : 788 -795 . DOI: 10.20043/j.cnki.MPM.202509445
正文
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高血压是心脑血管疾病的核心危险因素，伴随全球人口老龄化与生活方式转变，其患病率持续上升[1]。尽管降压治疗显著降低了心脑血管事件的发生率和死亡率，但高血压患者的相关死亡风险依然居高不下[2]。低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）作为心血管疾病的独立危险因素，广泛被应用于心血管疾病的风险评估中[3]。现有研究证实LDL-C水平升高与心脑血管疾病的发生密切相关，但这些研究大多集中于一般人群或单一慢性病患者，针对高血压及共病患者的研究相对匮乏。高血压患者常伴有糖尿病、慢性阻塞性肺病、代谢综合症等多种共病，这些共病进一步加重了患者的心血管疾病负担[4]。而LDL-C在这些群体中的作用尚未得到充分阐明，尤其是其与全因死亡及心脑血管死亡风险之间的关系仍存在争议[5-6]。因此，本研究旨在系统评估高血压及其共病患者LDL-C水平与全因死亡及心脑血管死亡风险之间的关系，以期为该人群的风险评估和个性化管理提供更加精确的科学证据，推动相关临床实践的优化。
1　材料与方法
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1.1　研究对象
基于贵州省自然人群队列研究，在2010年采用多阶段整群分层随机抽样的方法对贵州省12个区（县）9 280名18岁以上常住居民进行基线调查，于2016年12月—2020年6月和2023年12月对基线调查的研究对象进行追踪随访，共计随访到9 263人，失访17人，随访率达99.8%。排除相关数据缺失（N=73）、基线非高血压（N=6 764）参与者，最终有2 426名高血压患者纳入分析，其中包括高血压共病患者1 569人。见图1。本项目经贵州省疾病预防控制中心伦理委员会批准（编号：S2017-02），所有研究对象均自愿参加并签署知情同意书。
1.2　研究方法
1.2.1　问卷调查
数据由统一接受过培训的调查人员进行的面对面访谈收集的，调查问卷由中国疾病预防控制中心提供[7]，内容包括一般人口学特征（年龄、性别、民族、城乡、教育水平及婚姻状况）、行为生活方式（吸烟、饮酒）、饮食情况、疾病史及家族史等资料。
1.2.2　体格检查和生化指标检测
使用欧姆龙HEM7071 电子血压计，在调查对象清晨空腹测量血压，3 次取均值、使用TZG-210 身高坐高计测身高体重，2 次取均值。采集空腹静脉血 5 ml，4h 内检测空腹血糖(fasting blood glucose)，血清 - 20℃保存后采用奥林巴斯 AU400 全自动生化分析仪测定总胆固醇(total cholesterol)、甘油三酯(triglyceride)、高密度脂蛋白胆固醇(high density lipoprotein dholesterol,HDL-C)和LDL-C等。
1.2.3　相关定义标准
（1）高血压[8]：自报由医生诊断为高血压或进行降压治疗或收缩压≥140 mm Hg （18.6 kPa） 和/或舒张压≥90 mm Hg（12.0 kPa）。
（2）糖尿病[8]：空腹血糖水平≥7.0 mmol/L 或口服葡萄糖耐量试验血糖水平≥ 11.1 mmol/L 及已被乡镇或社区及以上医院诊断患有糖尿病的人群。
（3）慢性阻塞性肺病（chronic obstructive pulmonary disease,COPD）:自报由医生诊断。
（4）心脑血管疾病（cardiovascular diseases,CVD）：①自报由医生明确诊断；②死亡病例依据根本死因为心肌梗死/脑出血/脑梗死/脑梗塞等；以上两条满足一条即为CVD。
（5）抑郁[9]：本研究采用抑郁症状筛查量表患者健康问卷（patient health questionnaire，PHQ）评估心理健康状况，根据PHQ-9得分定义，0～4分为无抑郁，≥5分为抑郁。
（6）高甘油三酯血症[10]：甘油三酯≥2.3 mmol/L(200mg/dl)。
（7）低高密度脂蛋白血症[11]：HDL-C<1.0 mmol/L(40 mg/dl)。
（8）高血压共病：若研究对象患高血压的同时患有以上慢性病中的一种及以上则为共病。
（9）有害饮酒[12]：男性日均饮酒量≥61 g；女性日均饮酒量≥41 g。
（10）目前吸烟情况：调查时仍每日吸烟或偶尔吸烟。
（11）根据《中国居民膳食指南2022》[13]，食盐摄入量<5g/d、食用油摄入量≤25g/d、蔬菜水果摄入量>500g/d为健康饮食方式。
（12）身体质量指数（body mass index,BMI）：体重（kg）/身高的二次方（m2），BMI<18.5 kg/m2为轻体重，18.5 kg/m2≤BMI<24 kg/m2为正常体重，24 kg/m2 ≤BMI<28 kg/m2为超重，BMI≥28 kg/m2为肥胖[8]。
（13）死亡结局：本研究死亡分为全因死亡及心脑血管死亡，根据《疾病和有关健康问题的国际统计分类（第十次修订本）》[14]的疾病分类，判断根本死亡原因，其中全因死亡为包括创伤在内的所有原因造成的死亡，心脑血管死亡是指由心肌梗死、脑出血、脑梗死、脑梗塞导致的死亡。CVD死因编码为 I00～I99。
1.3　统计学分析
所有资料统计学分析采用SPSS 26.0统计软件和R 4.2.3。对不服从正态分布的连续性变量以［M（P25，P75）］表示，采用Mann-Whitney U非参数检验；分类变量用率或构成比（%）表示，组间比较采用χ2检验。参与者的LDL-C水平根据基线水平以四分位数均分为四组，以 Q1组为参照水平（Q1组：<2 mmol/L；Q2组:2～2.63 mol/L；Q3组：2.64～3.34 mol/L；Q4组：≥3.35 mol/L)。使用舍恩菲尔德（Schoenfeld）残差来检验等比例风险假设，主要变量符合等比假设（P>0.05），则采用 COX 比例风险模型分析LDL-C水平的连续变量和分类变量与高血压及其共病患者全因死亡和心脑血管死亡风险，关联强度用风险比和95%置信区间表示。本研究使用R.4.2.3软件绘制限制性立方样条(restricted cubic splines,RCS)图、森林图。双侧检验,检验水准α=0.05。
2　结果
收起
2.1　调查对象的基线特征
研究共纳入2 426名高血压调查对象，其中共病患者1 569名（64.7%）、高血压男性患者1 284（52.9%）、汉族患者1 513（62.4%），男性共病患者812（51.8%）、汉族共病患者976（62.2%）；高血压患者随访总人年为28 067.09年，中位随访时间为11.69年。LDL-C水平在高血压人群的民族、BMI、食用油摄入、盐摄入、静态时间、高甘油三酯血症、COPD、低高密度脂蛋白血症以及收缩压中有统计学差异，在共病人群的BMI、食用油摄入、盐摄入以及收缩压中有统计学差异(P<0.05)。见表1。
2.2　LDL-C水平与高血压患者全因死亡、心脑血管死亡的COX比例风险回归分析
调整相关变量后，模型3显示，Q3和Q4组人群高血压患者全因死亡风险为Q1组人群的1.750倍(HR=1.750，95% CI：1.152～2.656)、2.650倍(HR=2.650, 95% CI：1.736～4.045)；Q4组人群心脑血管死亡风险分别为Q1组人群的1.964倍(HR=1.964，95% CI：1.065～3.621)。随着LDL-C水平升高，全因死亡、心脑血管死亡风险也随之增高(P趋势 <0.001，P趋势=0.02)。见表2。
2.3　LDL-C水平与高血压共病患者全因死亡、心脑血管死亡的COX比例风险回归分析
调整相关变量后，模型3显示，Q2、Q3和Q4组人群高血压共病患者全因死亡风险分别为Q1组人群的1.601(HR= 1.601，95% CI：1.012～2.534)、2.082 (HR=2.082，95% CI：1.278～3.390)和2.874倍(HR=2.874, 95% CI：1.700～4.858)；Q4组人群心脑血管死亡风险分别为Q1组人群的2.592倍(HR=2.592, 95% CI：1.265～5.314)。随着LDL-C水平升高，血压共病患者的全因死亡、心脑血管死亡风险也随之增高(P趋势<0.001，P趋势= 0.013)。见表3。
2.4　LDL-C水平对高血压患者及其共病患者全因死亡、心脑血管死亡风险的剂量反应关系
采用RCS研究LDL-C水平对高血压患者及其共病患者全因死亡和心脑血管死亡风险之间的关系。RCS分析显示，高血压患者的全因死亡和心脑血管死亡风险趋势是随着LDL-C水平升高而升高，特别是当LDL-C水平超过2.713和2.650 mmol/L时，全因死亡和心脑血管死亡呈现显著上升趋势；高血压共病患者的全因死亡和心脑血管死亡风险在LDL-C水平超过2.016 和2.020 mmol/L时，全因死亡和心脑血管死亡风险增高。LDL-C水平对高血压及其共病患者全因死亡和心脑血管死亡风险之间是呈线性相关（P-nonlinear>0.05），且LDL-C与心脑血管死亡呈正相关。见图2。
2.5　敏感性分析
为排除恶性肿瘤和高龄对死亡风险的影响，在高血压人群中剔除基线恶性肿瘤8人和年龄大于85岁19人，在高血压共病人群中剔除恶性肿瘤7人和年龄大于85岁11人后进行敏感性分析，结果依然稳健。见图3。
3　讨论
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本研究发现，LDL-C每升高一个单位（1mmol/L），高血压患者的全因死亡和心脑血管死亡风险分别增加26.0%和17.3%；共病患者分别增加27.2%和23.3%，且呈线性剂量反应关系。当高血压患者LDL-C水平超过2.713 mmol/L（全因死亡）和2.650 mmol/L（心脑血管死亡）时，死亡风险呈现显著上升趋势；共病患者的风险临界点则降至2.016 mmol/L（全因死亡）与2.020 mmol/L（心脑血管死亡），这一发现为优化人群的血脂管理策略提供了关键阈值参考，为优化血脂管理降低患者的死亡风险提供了新的证据。
既往研究显示，LDL-C水平升高与全因死亡风险增加相关[15]，但相关证据多来自普通人群和单一慢病患者。韩国针对2型糖尿病合并症患者的研究显示[16]，LDL-C水平与心肌梗死、脑卒中等复合心血管事件风险存在显著剂量反应关系，70～<100 mg/dl和 100～<130 mg/dl 组的复合结局发生风险分别增加 12%（HR=1.12，95% CI：1.07～1.17）和 20%（HR= 1.20，95% CI：1.15～1.26）；一项荟萃分析也验证了LDL-C水平与心脑血管死亡风险的正相关性（HR= 1.21,95% CI：1.09～1.35）[17]。然而日本社区居民的队列研究呈现相反趋势[18]，LDL-C<70mg/dl 组全因死亡风险最高（HR=2.54，95% CI：1.58～4.07），70～92 mg/dl组（HR=1.71，95% CI：1.15～2.54）和 93～143 mg/dl 组（HR=1.21，95% CI：0.87～1.68）风险依次降低，而在普通老年人群中未观察到LDL-C水平与全因死亡的关联[19]。
本研究发现LDL-C与全因和心脑血管死亡风险之间呈线性相关，提示高血压患者应将LDL-C控制于2.650 mmol/L以下；共病患者LDL-C水平需控制在2.016 mmol/L以下，这与中国血脂指南中高危人群的降脂目标一致[20]。然而，在发达国家的研究中，LDL-C水平与全因死亡呈U型关联[21-22]受到了很大关注，显示LDL-C在极低或极高水平下都会增加其死亡风险[23]。而本研究显示，LDL-C低于2.016 mmol/L时，全因死亡风险HR<1，提示高风险人群应将LDL-C水平控制低于2.000 mmol/L，这与美国指南中对于高危人群推荐更低LDL-C的目标更为契合[24]。这些结果差异的原因可能与研究人群的特征、设计及LDL-C测量差异等因素相关。
本研究进一步发现，高血压共病患者的死亡风险对LDL-C水平变化更为敏感，且风险升高阈值显著低于单纯高血压患者，LDL-C每增加1个单位，共病患者全因死亡及心脑血管死亡风险均显著高于单纯高血压的患者。RCS结果显示，当风险比为1时共病患者对应的LDL-C水平值比高血压患者对应的值更低，提示即使在较低的LDL-C水平下，共病患者的死亡风险仍可能升高。其潜在机制可能在于，多种共病与高血压存在协同放大效应。糖尿病、血脂异常本身可加剧内皮功能障碍、氧化应激及慢性炎症，与高血压所致血流动力共同作用，加速动脉粥样硬化进程并导致斑块不稳定[25]。多种慢病的相互影响使得共病患者血管系统对LDL-C致病作用更加敏感，即使LDL-C水平处于2.016mmol/L时，仍可驱动共病患者死亡风险显著上升。本研究基于贵州省人群数据，结果与中国及国际血脂管理指南中对合并多危险因素患者定义为“极高危”并提出严格降脂目标的指导原则相一致[20,24]，为界定该类高危人群风险显著上升的血脂临界点提供了重要参考。
综上所述，本研究证实 LDL-C 是高血压及其共病患者全因死亡和心脑血管死亡的独立危险因素，强调了强化血脂管理的重要性。对于高血压共病患者，应将 LDL-C 降至 2.020 mmol/L 以下，并将共病作为强化降脂治疗的重要依据，以进一步降低心脑血管事件和死亡风险。本研究为该人群的血脂干预策略及个体化风险管理提供了新的科学依据。
基金
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  • 贵州省科技计划项目(黔科合支撑[2018]2819)
  • 分子诊断研究中心(贵州中医药大学ZX合字［2024］023号)
文献
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2026年第53卷第5期
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doi: 10.20043/j.cnki.MPM.202509445
  • 接收时间：2025-09-25
  • 首发时间：2026-11-02
  • 出版时间：2026-03-10
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  • 收稿日期：2025-09-25
基金
贵州省科技计划项目(黔科合支撑[2018]2819)
分子诊断研究中心(贵州中医药大学ZX合字［2024］023号)
作者信息
    1.贵州中医药大学基础医学院，贵州 贵阳 550025
    2.铜仁职业技术大学护理学院
    3.贵州医科大学公共卫生与健康学院
    4.贵州省疾病预防控制中心慢性病防治研究所，贵州 贵阳 550004

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Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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