了解高血压患者脑卒中的发病趋势与规律特征，为今后社区脑卒中的预防与控制提供参考依据。

通过随访观察队列研究，回顾性收集自2002年正式建立并实施高血压随访管理系统至2020年9月30日高血压随访管理系统中上海市嘉定区168 417例高血压患者的相关信息，应用一般描述性统计方法与χ²检验分析高血压患者中脑卒中的高发时间、高发类型等特征规律。

共收集观察138 284例60岁及以上高血压患者，脑卒中累积发病率为10.0%（男性为10.11%、女性为9.89%），不同性别之间脑卒中发病率差异具有统计学意义（χ²=42.667，P＜0.001）。患者年龄越大，累积发病率越高（χ²=315.775，P＜0.001）。脑卒中是以脑梗死为主（占86.86%），其次是脑出血（占7.16%）与未分型脑卒中（占5.98%）。患者建卡时的血压值越高，脑卒中累积发病率也越高（χ²=58.095，P＜0.001）。单纯高舒张压患者的脑卒中累积发病率（28.69%）高于单纯高收缩压的患者（9.25%）与收缩压和舒张压均高的患者（10.32%），不同类型的高血压患者的脑卒中累积发病率不同，且差异具有统计学意义（χ²=37.451，P=0.005）。高血压患者会在随访观察1年内、4年与8年左右出现3个脑卒中发病高峰。5月与7月是发生脑卒中发病高峰的月份，不同月份之间的脑卒中发病例数差异具有统计学意义（χ²=170.874，P＜0.001）。不同季度之间的脑卒中发病数量也不同，第一季度病例数相对较少，第二季度病例数相对较多，不同季度之间的脑卒中病例数差异具有统计学意义（χ²=76.143，P＜0.001）。

高血压患者发生的脑卒中是以脑梗死为主，脑卒中的累积发生率与患者的性别、年龄、血压值与血压类型有关，并呈现季节性特征。

To explore the incidence trend and epidemiological characteristics of stroke in elderly patients with hypertension, and to provide insights into the prevention and control of stroke in the community.

A followed-up cohort study of 168417 patients with hypertension were retrospectively analyzed, who were followed up in Jiading district in Shanghai from 2002. Relevant information of patients in The Hypertension Follow-up Management System was retrospectively collected, and the general descriptive statistical method and chi-square test were used to analyze the characteristics of high-incidence time and types of stroke in patients with hypertension.

The cumulative incidence of stroke was 10% (male 10.11%, female 9.89%) among 138284 patients with hypertension (χ²_sex=42.667, P＜0.001). The older the patient was, the higher the cumulative incidence was (χ²_age=315.775, P＜0.001). The most common type of stroke was cerebral infarction (86.86%), followed by cerebral hemorrhage (7.16%) and unclassified stroke (5.98%). The higher the blood pressure of patients was, the higher the cumulative incidence of stroke was (χ²_{BP grad}=58.095, P＜0.001). The cumulative incidence of stroke in patients with pure high diastolic blood pressure (28.69%) was higher than that in patients with pure high systolic blood pressure (9.25%) and high blood pressure (10.32%) (χ²_{HP type}=37.451, P=0.005). Three incidence peaks of stroke in patients with hypertension were within one year, four years and eight years after registered. May and July were the relative peak months of stroke (χ²_month=170.874, P＜0.001). The cumulative incidence of stroke was different among different seasons, showing seasonal characteristics (χ²_quarter=76.143, P＜0.001).

The major stroke type in patients with hypertension was cerebral infarction. The cumulative incidence of stroke was affected by sex, age, blood pressure value, and hypertension type. Incidence of stroke presents seasonal variations.