在血压值低于高血压值时,亚结骨下出血的风险会降低
Frederick Ewbank1, Benjamin Gaastra1,2, Samuel Hall1
1Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
European journal of neurology
|October 25, 2023
概括
较高的缩血压 (SBP) 显著增加了亚脑关节下出血 (SAH) 的风险. 即使是轻微升高的SBP水平,如120-130 mmHg,与较低水平相比,SAH风险的显著增加.
科学领域:
- 神经学 神经学
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 高血压是下关节出血 (SAH) 的一个成熟的危险因素.
- 了解血压水平与SAH发生率之间的准确关系对于公共卫生至关重要.
- 以前的研究表明存在联系,但需要对大量人群进行详细的分析和元分析.
研究的目的:
- 调查基线血压与动脉瘤下arachnoid出血 (SAH) 的风险之间的关联.
- 进行现有文献的元分析,以证实有关血压和SAH风险的发现.
- 确定SBP和SAH之间的关系 (线性或非线性) 的性质.
主要方法:
- 利用英国生物银行数据,追踪到2017年3月的500,598名个人.
- 采用考克斯的比例危险模型来分析系统血压 (SBP),透气血压 (DBP),平均动脉血压 (MABP) 和动脉瘤SAH之间的关联.
- 对电子数据库进行了系统的文献搜索,用于研究血压和SAH,数据搜索到2022年2月.
主要成果:
- 总共有539例动脉瘤SAH病例被确定.
- 对SAH的风险在较高的SBP时呈现线性增加,特别明显在120mmHg以上.
- 与SBP <120 mmHg的人相比,SBP 120-130 mmHg的人的风险高出41%,HR 1.41高于SBP <120 mmHg的人,这一发现与元分析一致.
结论:
- 在一般人群中,SAH发病率随着缩血压的增加而线性上升.
- 较低的SBP,特别是低于120mmHg,似乎与SAH风险降低有关.
- 这些发现强化了血压管理在预防SAH方面的重要性.
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