血圧測定と外周動脈疾患の関連
Nathan K Itoga1, Daniel S Tawfik2,3, Charles K Lee1
1Division of Vascular Surgery, Department of Surgery (N.K.I., C.K.L., N.J.L.), Stanford University School of Medicine, CA.
Circulation
|June 23, 2018
まとめ
低収縮血圧 (SBP) と高収縮血圧 (DBP) は,外周動脈疾患 (PAD) の発生と関連しています. PADの最適な血圧目標には,一般的な心血管のガイドラインを超えてさらなる調査が必要です.
科学分野:
- 心血管医学
- 臨床試験の分析
- 高血圧 研究
背景:
- 周辺動脈疾患 (PAD) に対する現在の高血圧ガイドラインは,心臓発作と脳卒中の減少に焦点を当てています.
- 血圧低下が下肢PADに与える影響は,まだ十分に研究されていない.
研究 の 目的:
- 血圧レベルと下肢PADの間の関連を調査する.
- 心臓発作を予防する抗高血圧および脂質低下治療 (ALLHAT) 試験のデータを分析する.
主な方法:
- ALLHAT試験の33,357人の参加者のデータを利用した.
- 拡張コックス回帰を用いて最初の下肢PAD発生までの時間を分析した.
- 静脈血圧 (SBP),静脈血圧 (DBP) と脈圧を時間変動変数として調べました.
主要な成果:
- SBP120~129mmHgと比較して,より高いおよび低いSBP (<120mmHgおよび≥160mmHg) はPADの発生リスクの増加と関連していました.
- 低血圧 (< 60 mmHg) はPADの発生リスクを有意に増加させた (HR,1. 72).
- 脈圧はPADのイベントとU型の関連性を示した.
結論:
- 非常に低いSBPと非常に高いSBPと,低いDBPは,下肢PADの発生率が高いと関連しています.
- 現在の一般的な血圧ガイドラインは,PADの最適な管理のために精細化する必要があるかもしれません.
- PAD患者のための特定の血圧目標値を確立するには,さらなる研究が必要です.
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