血圧管理と脳内出血の再発リスクとの関連
Alessandro Biffi1, Christopher D Anderson1, Thomas W K Battey1
1Center for Human Genetic Research, Massachusetts General Hospital, Boston2J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston3Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts Gener.
JAMA
|September 2, 2015
まとめ
脳内出血 (ICH) の後の低血圧は,再発したICHのリスクを大幅に高めます. 血行性脳卒中を生き延びた患者のさらなる発症を防ぐには,適切な血圧を維持することが重要です.
科学分野:
- 神経学
- 心血管医学
- 公衆衛生
背景:
- 脳内出血 (ICH) は重度の脳卒中であり,再発率は高い.
- ICHの生存者は 死亡率と機能低下の大きなリスクに直面します
研究 の 目的:
- ICH後血圧 (BP) と再発性ICHのリスクとの関連を調べる.
- 血圧制御が後の出血性脳卒中の可能性にどのように影響するかを調べる.
主な方法:
- ICHの生存者1145人を対象に実施した観察研究では,平均36. 8ヶ月間追跡調査を行った.
- 血圧は定期的にモニタリングされ,確立されたガイドラインに基づいて分類されました.
- 繰り返し発生するICHおよびその位置 (ロバル対非ロバル) を記録した.
主要な成果:
- 血圧の制御が不十分であることから, 葉帯性および非葉帯性ICHの再発のリスクがかなり高かった.
- 血圧の制御が不十分であった患者は,適切な制御であった患者より1. 7~2. 4倍高いイベント率を示した.
- フォローアップ中のシストリックおよびダイアストリック血圧の上昇は,再発のリスクの増加と関連していました.
結論:
- ICH後における不適切な血圧管理は,再発のより高いリスクと関連しています.
- これらの発見は,ICHの生存者にとって最適なBP目標を決定するための臨床試験の必要性を強調しています.
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