鉴定高血压患者的危险因素:随机对照试验的贡献通过个体患者数据库
F Gueyffier1, J P Boissel, S Pocock
1Clinical Pharmacology Department, Claude Bernard University, Lyon Hospitals, Lyon, France. fg@upcl.univ-lyon1.fr
Circulation
|November 5, 1999
概括
在高血压患者中预测心血管风险需要确定关键因素. 左心室缩是一个强有力的预测因素,而体重指数和心率不是,有助于有针对性的预防干预措施.
科学领域:
- 心脏病学 心脏病学
- 临床流行病学临床流行病学
背景情况:
- 准确预测个体风险对于高血压患者的有效预防干预至关重要.
- 识别预后因素和治疗修饰剂对于个性化风险评估至关重要.
研究的目的:
- 确定高血压患者心血管风险的预后因素.
- 探索高血压管理的潜在治疗修饰剂.
主要方法:
- 分析了8项受控试验的对照组中24390名高血压参与者的数据.
- 多变量生存模型被用来评估结果,包括冠心病死亡,中风死亡和5年内心血管死亡.
- 系统地探索试验之间的结果异质性.
主要成果:
- 电心图证实左心室缩症成为一个强大的风险因素,应纳入风险评分.
- 身高,膜过率和血清尿酸需要进一步调查,因为它们可能是潜在的危险因素.
- 身体质量指数和心率并未被证实是该人群中独立的心血管风险因素.
- 静脉压的预后值随年龄而有显著变化,在65岁之前显示出正相关性,随后显示出负相关性.
- 之前的抗高血压治疗被确定为一个显著的危险因素.
结论:
- 临床试验为完善风险预测模型提供了有价值的数据.
- 系统地分析试验之间的异质性可以提高研究结果的概括性.
- 这种方法可以改善风险变化因子的识别和预测个体治疗效益.
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