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在综合卫生系统内,从一个具有抗性高血压的大量多样化人口中进行过高血压查和发现
Victor Kim1, Jiaxiao Shi2, Jaejin An2,3
1Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
The Permanente journal
|November 27, 2023
概括
在耐性高血压 (RH) 中,对高阿尔多斯特 (HA) 的查较低,但阳性率很高. 针对性查和矿物质皮质类受体抗剂 (MRA) 的使用可以改善RH患者的血压控制.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
背景情况:
- 过高阿尔多斯特隆症 (HA) 是二次高血压的常见原因,也是抗性高血压 (RH) 的贡献者.
- 有效的HA查和管理对于改善RH患者的治疗结果至关重要.
- 目前的查实践及其在RH种群中的产量需要进一步调查.
研究的目的:
- 在耐高血压患者中确定和描述高阿尔多斯特症查率.
- 为了评估HA查在这个患者群体的阳性率.
- 评估矿物质皮质类受体抗剂 (MRA) 治疗在RH患者中的利用.
主要方法:
- 在2012年7月1日至2017年6月30日期间,使用来自南加州凯泽永久医院的数据进行了一项横截面研究.
- 耐性高血压是根据当代标准定义的,包括在多种药物下不受控制的血压.
- 主要结局是HA查率 (阿尔多和血雷宁活性测量);次要结局包括HA查阳性和MRA使用.
主要成果:
- 在102,480名RH患者中,只有1.9%的人接受了HA查,查的人中有36.8%的阳性率.
- 在整体RH队列中,MRA使用率为6.5%.
- 与HA查相关的因素包括黑人种族,低,高碳酸盐,CKD,OSA和静脉血压.
结论:
- 耐性高血压患者中存在低水平的HA查率,尽管阳性率高.
- 查HA和有针对性的MRA使用具有提高血压控制和RH结果的潜力.
- 与查相关的因素并不总是与积极的查结果相关,这凸显了需要精确的诊断策略的需要.
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