在高血压患者中,诊所访问间隔和长期心血管风险之间的关联
Duon Kim1, Hyunmook Jeong2, Suhyun Kim3
1Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Journal of clinical hypertension (Greenwich, Conn.)
|July 12, 2023
概括
对于高血压患者来说,3-6个月的更长的随访间隔是安全的,不会增加心血管风险. 这一发现支持潜在的降低管理高血压的医疗保健成本.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 高血压管理需要长期的患者随访,但最佳的访问间隔仍然没有定义.
- 建立适当的访问频率对于有效的慢性疾病管理和资源分配至关重要.
研究的目的:
- 为了研究中位访问间隔 (MVIs) 与高血压患者主要不良心血管事件 (MACEs) 的发生率之间的关联.
- 为了确定更长的随访间隔是否与大队列中心血管风险增加有关.
主要方法:
- 韩国高血压队列9894名高血压患者的数据分析,随访时间超过10年.
- 在4年的时间里,根据MVI (1,2,3,4和6个月) 将患者分为五组.
- 考克斯的比例危险模型被用来比较不同MVI组的MACE和全因死亡.
主要成果:
- 较长的访问间隔组 (3-6个月) 与较短的访问间隔相比,MACE的累积发病率没有增加.
- 随着MVI的延长,MACE或全因死亡的危险比率下降,六个月间隔显示风险明显降低 (HR:0.64).
- 在考克斯模型中使用了75-104天的MVI参考组进行比较.
结论:
- 在3-6个月的更长时间间隔进行随访,与高血压患者中MACE或全因死亡风险的增加无关.
- 一旦高血压药物稳定,将访问间隔延长到3-6个月似乎是合理的.
- 这种方法可以减少医疗保健费用,而不会影响心血管结果.
相关概念视频
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
27
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
27
01:29Hypertension II: Pathophysiology
20
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
20
01:28Hypertension I: Introduction
21
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
21
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
17
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
17
01:23Assessment of the Cardiovascular System I: Subjective Data
370
A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
370
01:18Hypertension and Regulation of Blood Pressure
2.1K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
2.1K