根据2017年ACC/AHA高血压指南将生物标志物纳入抗高血压药物的风险评估:聚合队列分析
在PubMed上查看摘要
概括
此摘要是机器生成的。生物标志物如高灵敏性心脏素T和NT-proBNP可以识别心血管事件高风险的高血压患者. 将这些生物标志物纳入风险评估可以改善高血压治疗决策.
科学领域
- 心脏病学
- 生物标志物研究
- 高血压管理
背景情况
- 2017年ACC/AHA血压指南引入了动脉样硬化心血管疾病的风险,以开始服用抗高血压药物.
- 慢性心肌损伤和压力生物标志物对高血压和高血压风险分层的作用尚不清楚.
研究的目的
- 调查心肌损伤的生物标志物 (高灵敏性心脏素T) 和压力 (NT-proBNP) 是否可以为患有高血压和高血压的成年人提供心血管风险分层和治疗决策.
主要方法
- 从3个队列研究 (ARIC,DHS,MESA) 的数据汇总,不包括心血管疾病的流行和抗高血压药的基线使用.
- 根据血压治疗组和生物标志物状态分层的参与者 (高灵敏度心脏素T ≥6 ng/ L,NT-proBNP ≥100 pg/ mL).
- 估计心血管事件的累积发病率和为密集降低血压治疗所需的10年数.
主要成果
- 包括12987名参与者;在10年内发生825起CV事件.
- 没有推药物的高血压:10年的心血管发病率为11.0%与高生物标志物相比,为4.6%.
- 服用推药物的1或2阶段高血压,10年内心血管发生率为高生物标志物的15. 1%,低生物标志物的7. 9%.
结论
- 高敏感性心脏托波宁T或NT-proBNP可以识别患有高血压或高血压的高风险个体,目前不建议服用药物.
- 没有升高的生物标志物的风险较低,即使在第一或第二阶段的高血压.
- 将生物标志物纳入风险算法可以优化密集的血压控制与患者风险的匹配.
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