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Disorders of Erythrocytes
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Umbral de diagnóstico para el monitoreo ambulatorio de la presión arterial basado en el riesgo cardiovascular a 10
Masahiro Kikuya1, Tine W Hansen, Lutgarde Thijs
1Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, Japan.
Circulation
|April 11, 2007
Resumen
Los nuevos umbrales de presión arterial ambulatoria (PAA) basados en resultados cardiovasculares son más bajos de lo que sugieren las directrices actuales. Estos hallazgos proporcionan un marco de referencia más preciso para el diagnóstico de la hipertensión utilizando el monitoreo ABP.
Área de la Ciencia:
- Cardiología Cardiología.
- Investigación de la Hipertensión Investigación de la Hipertensión
- Salud Pública La salud pública.
Sus antecedentes:
- Los criterios actuales de diagnóstico de la presión arterial ambulatoria se basan en las normas estadísticas de las poblaciones de referencia.
- Se necesitan umbrales basados en resultados para evaluar mejor el riesgo cardiovascular.
Objetivo del estudio:
- Establecer un marco de referencia orientado a los resultados para la medición ambulatoria de la presión arterial (PAB).
- Determinar los umbrales de PBA asociados con riesgos cardiovasculares específicos a 10 años.
Principales métodos:
- Monitoreo de ABP las 24 horas en 5682 participantes en cuatro estudios internacionales de población prospectiva.
- Análisis multivariados para identificar los umbrales de PBA vinculados a los riesgos definidos de eventos cardiovasculares.
- Seguimiento longitudinal para los puntos finales cardiovasculares (accidente cerebrovascular, eventos cardíacos).
Principales resultados:
- Identificó umbrales de PBA sistólica/diastólica para las categorías óptima, normal e hipertensa en períodos de 24 horas, día y noche.
- Los umbrales óptimos de ABP (redondeados): 115/75 mm Hg (24h), 120/80 mm Hg (día), 100/65 mm Hg (noche).
- Los umbrales normales de ABP (redondeados): 125/75 mm Hg (24h), 130/85 mm Hg (día), 110/70 mm Hg (noche).
Conclusiones:
- Los umbrales de ABP basados en la población y los resultados son más bajos que las recomendaciones actuales de la guía de hipertensión.
- El estudio proporciona un enfoque más preciso y estratificado de riesgo para diagnosticar la hipertensión a través del monitoreo de ABP.
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