血压变化,累积血压和血压轨迹的比较,用于预测一般人群中的心血管事件
Minghui Bao1, Yongjian Song2, Xu Han3
1Department of Cardiology, Peking University First Hospital, Peking University, Beijing, China.
概括
系统血压轨迹 (trajSBP) 最好预测心血管事件与变化 (SBPV) 和累积BP (cumSBP) 相比. TrajSBP增强了风险分层和个人CV事件预测.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 生物统计学 生物统计学
背景情况:
- 缩血压变化 (SBPV),累积缩血压 (cumSBP) 和缩血压轨迹 (trajSBP) 是血压变化的关键指标.
- 准确预测心血管 (CV) 事件对于有效的患者管理至关重要.
研究的目的:
- 为了比较SBPV,cumSBP和trajSBP对预测CV事件的歧视能力.
- 评估这些BP指数在不同心血管风险层中的附加值.
主要方法:
- 考克斯回归分析用于51698名受试者的队列.
- 根据弗雷明汉风险评分 (FRS),参与者被分为10年低,中,高心血管风险组.
- 用曲线下的面积 (AUC),哈雷尔的C指数,净重新分类指数 (NRI) 和综合歧视指数 (IDI) 来评估歧视.
主要成果:
- 这三种标志物 (SBPV,cumSBP, trajSBP) 都与心血管事件有显著的关联.
- TrajSBP表现出最强的额外歧视值,显著改善了AUC,哈雷尔的C,NRI和IDI.
- 在中高风险群体中,CumSBP表现出良好的区分能力,而在中低风险群体中,SBPV表现出较小的改善.
结论:
- 静心血压轨迹 (trajSBP) 与传统的风险因素相结合时,为心血管事件提供了最佳的额外歧视.
- TrajSBP可能会增强心血管风险分层和对未来心血管事件的个体预测.
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