血压,C反应蛋白,以及未来心血管事件的风险
Gavin J Blake1, Nader Rifai, Julie E Buring
1Center for Cardiovascular Disease Prevention and the Donald W. Reynolds Center for Cardiovascular Research, Boston, Mass, USA. gblake@mater.ie
Circulation
|November 26, 2003
概括
高血压和C反应蛋白 (CRP) 独立地预测心血管事件. 结合高血压和CRP显著增加心血管风险,突出了它们对心脏健康的附加预后价值.
科学领域:
- 心血管医学 心血管医学
- 炎症研究 炎症研究
- 公共卫生 公共卫生
背景情况:
- 新出现的证据将高血压与血管炎症联系在一起.
- C-反应蛋白 (CRP) 是与心血管疾病相关的关键炎症标记物.
- 了解血压和炎症之间的相互作用对于评估心血管风险至关重要.
研究的目的:
- 调查血压,CRP水平和女性第一次心血管事件的发生率之间的关系.
- 确定CRP是否为不同血压类别的心血管事件提供增量预后价值.
- 评估血压和CRP对心血管风险的联合和独立贡献.
主要方法:
- 一项前性队列研究,涉及15215名女性.
- 血压和C反应蛋白 (CRP) 水平的基线评估.
- 随访发生的第一个心血管事件,平均持续时间为8.1年.
- 统计分析,包括横截面和前性分析,危险比率和风险因素调整.
主要成果:
- 在增加的血压类别和基线中位CRP水平之间观察到显著的积极趋势 (P < 0.0001).
- 升高的CRP水平 (≥3 mg/L) 和高血压类别都是未来心血管事件的独立预测因素.
- 高血压 (≥160/95毫米) 和高CRP (≥3毫克/升) 的组合与心血管事件的风险比率 (8.31) 显著增加有关.
- 经风险因素调整的分析显示了附加效应:高CRP/低血压 (HR 1.87),低CRP/高血压 (HR 2.54) 和高CRP/高血压 (HR 3.27).
结论:
- 血压和CRP是心血管风险的独立决定因素.
- 对心血管事件的血压和CRP的预测值是附加的.
- 测量血压和CRP可以提高心血管风险分层.
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