在4D研究中的血压和死亡率
Babak Yazdani1, Marcus E Kleber1,2, Graciela E Delgado1,3
1Fifth Department of Medicine, University Medical Center Mannheim UMM, Faculty of Medicine of the University of Heidelberg, Mannheim, Germany.
Kidney & blood pressure research
|October 8, 2023
概括
像脉冲压 (PP) 这样的血压参数不能预测糖尿病透析患者的死亡率. 然而,PP的U曲线表明心血管死亡风险的最佳范围.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
背景情况:
- 静心血压 (SBP),静心血压 (DBP) 和平均动脉压 (MAP) 是已确定的心血管死亡 (CVM) 风险因素.
- 脉压 (PP) 是衡量血管硬度的指标,在接受慢性透析的糖尿病患者中对CVM的预后价值尚不清楚.
研究的目的:
- 调查2型糖尿病血液透析患者中CVM的基线预分析前血压参数 (PP,SBP,DBP,MAP) 的预测值.
主要方法:
- 一项前性,随机,双盲试验 (德国糖尿病和透析 [4D]研究) 涉及1,255名患者.
- 分析基线PP,SBP,DBP和MAP作为连续变量和三级变量.
- 在死亡率预测模型中调整年龄和性别.
主要成果:
- 单独来看,PP,MAP,SBP和DBP在分析为连续变量或三位数时没有显著预测心血管或全因死亡率.
- 对PP观察到U形曲线,涉及所有原因死亡率和CVM,风险最低在70-80mmHg范围内.
结论:
- 进入研究时的血压前分析参数并不是末期病患者长期糖尿病患者死亡率的显著预测指标.
- 竞争性死亡风险因素的高率可能会掩盖血压控制在这个人群中的影响.
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