单个与联合的血压成分和心血管疾病风险:弗雷明汉心脏研究
Stanley S Franklin1, Victor A Lopez, Nathan D Wong
1Heart Disease Prevention Program, Department of Medicine, C240 Medical Sciences, University of California, Irvine, CA 92697, USA. ssfranklinmd@earthlink.net
结合血压的组成部分,如静脉和腹血压,或脉冲压和平均动脉压,与单个措施相比,改善了心血管疾病事件预测. 风险因组件水平而有所不同.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 对心血管疾病 (CVD) 事件单个与联合血压 (BP) 组件的预测价值仍然不清楚.
- 这项研究研究了静脉压 (SBP),静脉压 (DBP),脉冲压 (PP) 和平均动脉压 (MAP) 单独和组合对心血管疾病事件预测的实用性.
研究的目的:
- 为了比较单个BP组件与联合BP组件 (SBP+DBP和PP+MAP) 在预测心血管疾病事件中的有效性.
- 评估结合不同BP测量的增量预测值.
主要方法:
- 利用了来自弗雷明汉心脏研究 (原始和后代队列) 的数据,其中包括9657名参与者.
- 使用聚合后勤回归与BP组件进行分类和连续分析.
- 评估的模型符合BP组件之间的改进和显著相互作用.
主要成果:
- 结合BP组件 (SBP+DBP和PP+MAP) 与单个BP组件 (P<0.05到P<0.0001) 相比,显著改善了模型匹配.
- 在SBP和DBP (P=0.02) 和PP和MAP (P=0.01) 之间观察到显著的相互作用.
- 使用连续SBP+DBP和PP+MAP的模型显示CVD事件的预测性能相同. 添加一个二次 DBP 项进一步增强了预测.
结论:
- 结合BP组件 (PP+MAP和SBP+DBP) 与单个BP组件相比,可以更好地预测心血管疾病事件.
- 综合措施的预测能力因每个组件的水平而异.
- 虽然PP+MAP可能提供血液动力学见解,但SBP+DBP对心血管疾病事件具有相似的预测能力.
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