ジャクソン心臓研究におけるアフリカ系アメリカ人の通行血圧の限界値

Joseph Ravenell¹, Daichi Shimbo², John N Booth²

¹From Department of Population Health, New York University School of Medicine (J.R., T.M.S., A.J.S., G.O.); Department of Medicine, Columbia University, New York (D.S., M.A.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center for Minority Health & Health Disparities Research and Education, Xavier University of Louisiana, New Orleans (D.F.S.); Department of Public Health, Amsterdam Medical Centre, University of Amsterdam, The Netherlands (C.A.); Department of Psychology, University of Maryland, Baltimore County (D.L.B.M.); and Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City (A.P.B.). joseph.ravenell@nyumc.org.

Circulation

|April 22, 2017

まとめ

この研究は,米国の人口ベースのサンプルを用いて,アフリカ系アメリカ人の成人に対する新しい出院高血圧の値を確立しています. この調査結果は,この集団における高血圧の診断と管理に重要な指針を提供します.

科学分野:

心臓病科
公衆衛生
流行病学について

背景:

診療室外での血圧測定は,標準的な基準です.
既存の高血圧の基準は,アメリカ以外の国の人口に基づいているので,人種/民族特有のデータが必要である.
アフリカ系アメリカ人の成人では高血圧や心血管疾患が多く見られます

研究の目的:

アメリカのアフリカ系アメリカ人の成人のサンプルで,歩行性高血圧の特定の血圧の値を決定する.
回帰と結果に基づくアプローチから得られた値を比較する.
この集団における高血圧管理のための臨床ガイドラインを提示する.

主な方法:

ジャクソン・ハート・スタディのデータを分析し,非アメリカ系成人のコホート (n=1016) で出院式血圧モニタリングを行った.
昼間,24時間,夜間における平均シストリックBP (SBP) とダイアストリックBP (DBP) の計算
高血圧の値の特定は,回帰と心血管/死亡結果による方法を使用して,薬剤使用によって層分化されます.

主要な成果:

140/ 90 mm Hgの臨床血圧に対応する昼間,24時間,夜間SBP/ DBPの回帰値 (非薬用) は134/85,130/81,123/ 73 mm Hgであった.
140mmHgの臨床SBPに対応する昼間,24時間,夜間SBPはそれぞれ138mmHg,134mmHg,129mmHgでした.
抗高血圧薬を服用した参加者の値はわずかに変化し,結果から派生したSBP値は高かった.

結論:

アフリカ系アメリカ人の成人における ambulatory hypertension (アウトカム派生SBPと回帰派生DBP) の定義は,臨床的に≥140/ 90 mm Hgに対応しています.
日間:SBP/DBP ≥140/85 mmHg
24時間:SBP/DBP ≥135/80 mmHg
夜間:SBP/DBP ≥130/75 mm Hg

キーワード:

アフリカ系アメリカ人の成人循環器による血圧モニタリング高血圧

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