血压测量与周围动脉疾病事件的关联
Nathan K Itoga1, Daniel S Tawfik2,3, Charles K Lee1
1Division of Vascular Surgery, Department of Surgery (N.K.I., C.K.L., N.J.L.), Stanford University School of Medicine, CA.
Circulation
|June 23, 2018
概括
低静脉血压 (SBP) 和高静脉血压 (DBP) 与周围动脉疾病 (PAD) 相关. 对PAD的最佳血压目标需要进一步研究,而不仅仅是一般的心血管指南.
科学领域:
- 心血管医学
- 临床试验分析
- 高血压研究
背景情况:
- 目前对外围动脉疾病 (PAD) 的高血压指南侧重于减少心脏事件和中风.
- 降低血压对下肢PAD事件的影响仍未得到充分研究.
研究的目的:
- 研究血压水平与下肢PAD事件之间的关联.
- 分析抗高血压和降脂治疗预防心脏病发作 (ALLHAT) 试验的数据.
主要方法:
- 使用了来自ALLHAT试验的33357名参与者的数据.
- 使用扩展的考克斯回归分析了第一个下肢PAD事件的时间.
- 作为时间变量的静脉血压 (SBP),静脉血压 (DBP) 和脉冲压的检查.
主要成果:
- 与SBP120-129 mmHg相比,较高和较低的SBP (<120 mmHg和≥160 mmHg) 与PAD发生的风险增加有关.
- 较低的DBP (<60 mmHg) 显著增加了PAD事件的危险性 (HR,1. 72).
- 脉冲压与PAD事件呈现出U形的关联.
结论:
- 非常低和非常高的SBP,以及低的DBP,都与较高的下肢PAD事件相关.
- 目前的一般血压指南可能需要改进以实现最佳的PAD治疗.
- 需要进一步的研究来确定PAD患者的特定血压目标.
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