基线血清胆固醇与密集血压控制的好处的关联
Xiaoqi Wang1, Yingqing Feng2, Li Yang3
1Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
Chinese medical journal
|August 1, 2023
概括
密集的静脉压控制有利于高血压患者的心血管结果. 然而,像LDL-C和非HDL-C这样的基线胆固醇水平并没有影响这种密集的血压管理策略的有效性.
科学领域:
- 心脏病学 心脏病学
- 高血压管理 高血压管理
- 脂质代谢 脂质代谢是什么
背景情况:
- 在STEP试验中,强化系统性血压 (SBP) 控制显示了改善的结果.
- 基线血清脂质参数对SBP密集控制的益处的影响仍然不清楚.
研究的目的:
- 调查基线低密度脂蛋白胆固醇 (LDL-C) 和非高密度脂蛋白胆固醇 (非HDL-C) 度是否会改变SBP密集控制的效果.
- 分析SBP干预和基线脂质水平与心血管疾病事件之间的相互作用.
主要方法:
- 随机对照STEP试验中的8283名参与者的特异分析.
- 强化 (SBP目标110至130毫米) 与标准 (SBP目标130至150毫米) SBP控制的比较.
- 基于基线LDL-C和非HDL-C水平的初级复合心血管疾病事件差异的检查.
主要成果:
- 基线的LDL-C和非HDL-C显示了与主要结果的J形关联,而不管SBP干预.
- 在密集的SBP干预和基线LDL-C (P=0.80) 或非HDL-C (P=0.95) 水平之间没有发现显著的相互作用.
- 亚组分析表明,在LDL-C和非HDL-C的最高三位数中,潜在的益处是显著的,但整体相互作用P值并不显著 (分别为0.49和0.47).
结论:
- 血清LDL-C和非HDL-C度的升高与心血管事件的更高风险有关.
- 该研究没有发现任何证据表明基线脂质水平会改变SBP密集控制在老年高血压患者的心血管益处.
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