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冠状动脉将指导基于风险的个性化方法,启动和加强抗高血压治疗.

John W McEvoy1, Seth S Martin2, Zeina A Dardari2

  • 1From Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., S.S.M., Z.A.D., W.S.P., K.N., R.S.B., M.J.Blaha); Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, MN (M.D.M.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (V.S.); Heart and Vascular Center of Excellence, Wake Forest Baptist Health, Winston-Salem, NC (J.Y.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J.Budoff); Department of Epidemiology, Colorado School of Public Health, Aurora (D.C.G.); Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle (B.M.P.); and Center for Healthcare Advancement and Outcomes and Miami Cardiac and Vascular Institute, Baptist Health South Florida (K.N.). jmcevoy1@jhmi.edu.

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概括

冠状动脉 (CAC) 成像可以帮助个性化静脉血压 (SBP) 治疗强度. 与动脉样硬化心血管疾病 (ASCVD) 风险相结合的CAC指导着SBP目标,特别是在高血压前期或轻度高血压患者中.

关键词:
抗高血压药物治疗方法心血管疾病的风险.冠状动脉 冠状动脉压缩性血压 压缩性血压是一种血压.

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科学领域:

  • 心脏病学 心脏病学
  • 预防医学 预防医学
  • 医疗成像医学成像

背景情况:

  • 使用动脉样硬化心血管疾病 (ASCVD) 风险个性化静脉压 (SBP) 治疗目标越来越重要.
  • 冠状动脉 (CAC) 图像可能为抗高血压药物治疗强度提供进一步指导.

研究的目的:

  • 调查CAC成像是否可以完善SBP的治疗强度分配.
  • 评估CAC在心血管风险分层中的作用,超出传统的ASCVD风险得分.

主要方法:

  • 对3733名多民族动脉样硬化研究 (MESA) 参与者的分析,SBP 120-179 mm Hg.
  • 根据SBP的分层,10年ASCVD风险和CAC得分 (0,1-100,>100).
  • 对ASCVD或心力衰竭的多变量调整危险比率的比较,以及对SBP强化目标治疗所需人数的估计.

主要成果:

  • 在SBP<160mmHg的个体中,CAC显著分层事件风险,特别是当ASCVD风险<15%时.
  • 例如,在那些ASCVD风险<15%和SBP 120-159 mm Hg的人群中,较高的CAC得分与事件危险比率的增加相关.
  • 当SBP为160-179毫米升时,无论ASCVD风险如何,没有观察到CAC和事件之间的明显关联.

结论:

  • 结合CAC成像和ASCVD风险评估可以指导个性化的SBP治疗目标 (例如,140与120毫米升).
  • 这种方法对于估计有5%-15%的ASCVD风险和高血压前期或轻度高血压的成年人来说尤其有益.
  • 在不符合更高ASCVD风险值的个体中,CAC成像增加了风险分层的价值.