强化降低血压改善了患有高血压的老年患者的左心室缩: STEP 试验
Yue Deng1, Wei Liu2, Xinchun Yang3
1Hypertension Center, FuWai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing (Y.D., J.C.).
Hypertension (Dallas, Tex. : 1979)
|June 1, 2023
概括
强化降低缩血压显著降低了老年高血压患者新出现左心室缩 (LVH) 的风险. 然而,这种保护作用并不能完全解释观察到的心血管事件的减少.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 临床试验 临床试验
背景情况:
- 密集的缩血压 (SBP) 降低越来越多地被利用,但它对心脏重塑的影响,特别是左心室缩 (LVH),需要进一步阐明.
- 本研究分析了老年高血压患者血压干预策略试验的数据,以评估SBP密集管理下的LVH变化.
研究的目的:
- 为了确定强化SBP降低对左心室缩 (LVH) 在老年高血压患者的发展和进展的影响.
- 评估与密集的SBP降低相关的心血管事件的减少是否通过LVH的变化来调解.
主要方法:
- 一项对7141名高血压患者的二次分析,随机分配到密集 (SBP目标,110-130毫米血压) 或标准 (130-150毫米血压) 治疗.
- 使用Peguero-Lo Presti标准对12心声图进行评估,随访时间中位数为3.24年.
主要成果:
- 强化降低SBP显著降低了新的LVH发生的风险 (HR,0.76;P=0.001) 并减缓了LVH的进展 (Peguero-Lo Presti平均值变化,-23.47μV/y).
- 群体之间的LVH回归率没有显著差异.
- 密集降低SBP (HR,0.75) 的心血管益处在将LVH作为共变量计算时没有得到实质性的改变.
结论:
- 强烈的SBP降低表明对患有高血压的老年人患有LVH的发展有保护作用.
- 虽然强化降低SBP有益于心脏重塑,但它不能完全解释这些患者观察到的心血管事件显著减少.
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