血压和不同抗高血压药物与缺血性中风后的结果之间的关联:孟德尔的随机化研究
Hanchen Liu1, Xiaoxi Zhang1, Yu Zhou1
1Neurovascular Center, Naval Medical University Changhai Hospital, Shanghai, China.
概括
高血压会增加缺血性中风后残疾的风险. ангиотензин转化酶抑制剂 (ACEI) 和通道阻断剂 (CCB) 在改善中风患者的结果方面表现有前途.
科学领域:
- 心血管研究研究心血管研究
- 遗传学 遗传学 是一个
- 神经学 神经学
背景情况:
- 观察性研究表明,缺血性中风患者的血压 (BP) 和功能结果之间存在联系,但因果关系仍然不确定.
- 混因素可能会影响观察到的关联,需要强大的分析方法.
研究的目的:
- 使用门德尔随机化 (MR) 来研究高血压与后缺血性中风功能结果之间的因果关系.
- 探索特定类型的抗高血压药物是否与改善的功能结果有关.
主要方法:
- 从757,601个个体的全基因组关联研究 (GWAS) 中,选择了与缩和腹缩血压和降血压基因相关的遗传变异.
- 评估主要结果 (3个月的依赖或死亡;mRS 3-6) 和次要结果 (90天的残疾或死亡;mRS 2-6).
- 采用了敏感性分析,包括科克兰的Q,加权中位数,MR-Egger和离开一个SNP的方法;进行独立的重复和双向MR分析进行验证.
主要成果:
- 遗传倾向于较高的静脉和腹血压显着与缺血性中风后残疾或死亡风险增加有关.
- 更高的脉压力也与更糟糕的功能结果相关.
- ангиотензин转化酶抑制剂 (ACEI) 和通道阻断剂 (CCB) 与改善的功能结果显著相关.
结论:
- 这项研究提供了证据支持基因高血压与缺血性中风后功能依赖的更高风险之间的因果关系.
- 研究结果表明,ACEI和CCB是有前途的抗高血压药物类,可以改善缺血性中风患者的功能恢复.
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