与标准血压控制相比,缩血压对强度控制的影响
Srinivasan Beddhu1,2, Glenn M Chertow3, Alfred K Cheung4,2
1Medical Service, Veterans Affairs Salt Lake City Health Care System, UT (S.B., A.K.C.) srinivasan.beddhu@hsc.utah.edu.
Circulation
|October 13, 2017
概括
通过强化降低静脉压 (SBP),在不同基线静脉压 (DBP) 水平上同样有利于心血管结果. 然而,低基线DBP独立增加心血管疾病的风险.
科学领域:
- 心脏病学
- 肝脏病学
- 临床试验
背景情况:
- 密集降低静脉压 (SBP) 在低静脉压 (DBP) 患者的影响尚不清楚.
- 高血压管理对于预防心血管疾病至关重要.
研究的目的:
- 调查基线DBP是否影响SBP强度降低对心血管疾病结果的有效性.
- 分析基线DBP与心血管疾病事件,全因死亡率和慢性病之间的关联.
主要方法:
- 对9361名患有高血压的老年人的SPRINT (静脉压干预试验) 的后期分析.
- 密集 (目标<120 mm Hg) 与标准 (目标<140 mm Hg) SBP控制的比较
- 根据基线DBP类别检查治疗效果的变化.
主要成果:
- 基线DBP与心脏病结局呈U型关联,这表明DBP水平低和高都会增加风险.
- 在所有基线DBP水平上,SBP强化干预对初级心脏病结局的影响是一致的 (相互作用P=0. 78).
- 对于包括全因死亡和偶发性慢性病在内的二次结局,也发现了类似的结果.
结论:
- 低基线DBP是心血管疾病事件的独立风险因素.
- 密集降低SBP的心血管益处不受基线DBP水平的影响.
- 这表明,在高风险的老年人中,无论初始的DBP如何,强化SBP目标都是有益的.
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