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Cambios posturales en la presión arterial diastólica y el riesgo de infarto de miocardio: el Estudio de
Circulation
|October 1, 1984
Resumen
Los cambios en la presión arterial postural, específicamente la diferencia entre la presión arterial diastólica de pie y supina (Delta DBP), predicen el riesgo de infarto de miocardio. Una DBP delta más alta amplifica la asociación entre la presión arterial sentada y la incidencia de ataque cardíaco.
Área de la Ciencia:
- Cardiología Cardiología.
- Gerontología Gerontología.
- La medicina preventiva es la medicina preventiva de las enfermedades.
Sus antecedentes:
- La regulación de la presión arterial puede variar con la postura.
- Comprender estas variaciones puede ofrecer información sobre el riesgo cardiovascular.
- El Estudio Normativo del Envejecimiento proporciona datos longitudinales sobre el envejecimiento y la salud.
Objetivo del estudio:
- Para investigar la asociación entre los cambios de presión arterial postural y el riesgo de infarto de miocardio.
- Para determinar si la relación entre la presión arterial sentada y el infarto de miocardio se modifica por las diferencias de presión arterial postural.
- Explorar la utilidad clínica de evaluar la capacidad de respuesta vascular.
Principales métodos:
- Estudio longitudinal de cohorte en el que participaron 1359 hombres.
- La duración promedio del seguimiento fue de 8,7 años.
- Análisis de la presión arterial sentada, la presión arterial supina y la incidencia de infarto de miocardio, considerando el delta DBP (presión arterial diastólica de pie menos supina).
Principales resultados:
- La asociación entre la presión arterial diastólica sentada y el riesgo de infarto de miocardio fue significativa principalmente en hombres con DBP delta ≥ 10 mm Hg.
- El riesgo de infarto de miocardio por presión arterial sistólica sentada fue evidente en todas las categorías de DBP delta, intensificándose con DBP delta más alto.
- La influencia del delta DBP en el riesgo de infarto de miocardio persistió incluso después de ajustar los factores de riesgo coronario estándar.
Conclusiones:
- Los cambios posturales en la presión arterial, cuantificados por delta DBP, están relacionados con el riesgo de infarto de miocardio posterior.
- La capacidad de respuesta vascular, como lo indica el delta DBP, puede ser un predictor independiente significativo de eventos cardiovasculares.
- La medición del delta DBP podría mejorar la evaluación del riesgo cardiovascular e informar la práctica clínica.
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