脈圧と新発性心房細動のリスク

Gary F Mitchell¹, Ramachandran S Vasan, Michelle J Keyes

¹Cardiovascular Engineering Inc, Waltham, Mass 02453, USA. garyfmitchell@mindspring.com

JAMA

|February 22, 2007

まとめ

大動脈の硬さの指標である脈圧の上昇は,心房細動 (AF) を発症させる重要な危険因子です. この発見は,AFの発生を防ぐためのターゲットとして脈圧を強調しています.

科学分野:

心臓病学心臓病学
エピデミオロジーエピデミオロジー
血管医学血管医学とは

背景:

心房細動 (AF) は,罹病率と死亡率に大きく寄与しています.
AFの修正可能な危険因子を特定することは,公衆衛生上の優先事項です.
脈圧の上昇は,大動脈の硬さを反映し,心臓の負荷を高め,AFのリスクを増加させる可能性があります.

研究の目的:

脈圧と心房細動の発生率との関係を調査する.
脈圧がAFの独立した危険因子であるかどうかを判断する.

主な方法:

展望型,コミュニティベースの観察コホート研究.
フレミングハム心臓研究 (Framingham Heart Study) の5331人の参加者 (35歳以上) が含まれており,当初はAFの症状はありませんでした.
事故AFを評価するために,参加者を平均12年間追跡した.

主要な成果:

脈圧の上昇は,AFを発症するリスクの有意な増加と関連していました.
AFの調整されたハザード比は,脈圧の20mmHgの上昇あたり1.26であった (P<.001).
平均動脈圧は,特定の脈圧効果を支える,インシデントAFに関連しませんでした.

結論:

脈圧は,一般集団におけるインシデントAFの重要な危険因子として特定されています.
AFの予防のためにパルス圧縮を標的とした介入を探るためのさらなる研究が必要である.

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