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  3. 研究分野
  5. 生物医学と臨床科学
  7. 心血管医学と血液学
  9. 心臓病 (心血管疾患を含む)
  11. 血圧を下げる治療の4つの戦略の適格性と,その後の心血管疾患の負担:遡及的なコホート研究

血圧を下げる治療の4つの戦略の適格性と,その後の心血管疾患の負担:遡及的なコホート研究

Emily Herrett1, Sarah Gadd1, Rod Jackson2

  • 1Department of Non-Communicable Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.

Lancet (London, England)
|July 30, 2019

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PubMed で要約を見る

まとめ
この要約は機械生成です。

心血管リスクに基づく戦略は,現在の血圧ガイドラインよりも多くの出来事を防ぐことができます. このアプローチは,既存の方法と比較して,心血管疾患の予防に類似した効果を示しています.

科学分野:

  • 心血管医学
  • 公衆衛生
  • 健康 経済

背景:

  • 現在の血圧の治療ガイドラインは 値に大きく依存しています
  • 血圧低下の利点は 患者全体に広がるという証拠があります
  • 高血圧管理のための代替戦略は調査を正当化します.

研究 の 目的:

  • 血圧の治療に適した患者を特定するための異なる戦略を比較する.
  • 各戦略で予防できる心血管疾患の数を推定する.
  • 英国における代替血圧治療戦略の影響を評価する.

主な方法:

  • イギリスのプライマリケアデータ (CPRD,HES,ONS) を用いた遡及コホート研究.
  • 心血管疾患のない30歳から79歳の患者も含まれていた.
  • 4つの適格性戦略を比較した. 2011年NICE,2019年NICE,BP値 (≥140/90 mmHg),QRISK2リスクスコア (≥10%).

主要な成果:

  • 平均4. 3年間,120万人を超える患者を追跡した.
  • 心血管リスクベースの戦略 (QRISK2 ≥10%) は,適格な患者を多く特定し,より多くのイベントを予防することができます.
  • イギリスの人口に拡大すると,QRISK2は322,921のイベントを回避でき,2011年のNICEガイドラインでは233,152のイベントを回避できた.

結論:

  • 心血管疾患リスクに基づく戦略 (QRISK2 ≥10%) は,心血管疾患を予防するより大きな可能性を秘めています.
  • このアプローチは,回避されたイベントごとに必要な処理の観点から,既存のガイドラインと比べられる効率性を示しています.
  • リスクベースの戦略は高血圧の管理に より効果的なアプローチを示します.

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