升高NT-proBNP的患病率及其通过血压治疗和控制的预后值
Natalie R Daya1, John W McEvoy2, Robert H Christenson3
1Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
NT-proBNP水平可以预测患有高血压的成年人死亡风险. 升高的NT-proBNP识别出具有较高全因和心血管死亡率的个体,有助于高血压管理.
科学领域:
- 心血管医学 心血管医学
- 生物标志物 生物标志物
- 公共卫生 公共卫生
背景情况:
- 在美国一般成年人群中,NT-proBNP在高血压中的预后效用还不清楚.
- 高血压影响了相当一部分成年人群,需要更好的风险分层工具.
研究的目的:
- 评估NT-proBNP在美国高血压成年人的预后价值.
- 为了确定NT-proBNP是否可以识别不同血压控制类别中死亡风险较高的个体.
主要方法:
- 从国家健康和营养检查调查 (1999-2004) 的血液样本中分析NT-proBNP水平.
- 在没有心血管疾病 (CVD) 的成年人中通过血压治疗和控制评估NT-proBNP的患病率.
- 检查NT-proBNP升高与死亡风险之间的关联,平均随访时间为17.3年,经过对共变量进行调整.
主要成果:
- 升高NT-proBNP (≥125 pg/ml) 的患病率在未经治疗的高血压患者中为27.2%,在治疗的控制高血压患者中为24.9%,在治疗的控制高血压患者中为43.3%.
- 与低NT-proBNP的正常血压个体相比,在受治疗的控制高血压中,高NT-proBNP与所有原因 (HR 2.29) 和心血管死亡率 (HR 3.83) 的增加有关.
- 升高的NT-proBNP总是预测了所有静脉压水平的死亡风险增加,无论服用抗高血压药物.
结论:
- 在高血压成年人中,NT-proBNP提供了额外的预后信息,无论血压控制状态如何.
- 测量NT-proBNP可能有助于优化高血压治疗策略和风险分层.
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