高血压管理策略在SPRINT-符合条件的美国成年人中的有效性:模拟研究
Fengdi Zhang1, Kelsey B Bryant2, Andrew E Moran1
1Department of Medicine Columbia University New York NY USA.
Journal of the American Heart Association
|January 12, 2024
概括
密集的血压管理,就像SPRINT试验中的那样,每年可以在符合条件的美国成年人中预防超过138,000次心血管事件. 基于团队的护理提供了一种务实的方法来管理高血压风险.
科学领域:
- 心血管医学 心血管医学
- 公共卫生政策 公共卫生政策
- 高血压管理 高血压管理
背景情况:
- 在SPRINT试验中被证明有效的密集血压控制策略在美国尚未被广泛采用.
- 本研究评估了不同高血压管理策略对SPRINT资格成年人心血管疾病 (CVD) 事件的长期影响.
研究的目的:
- 模拟和比较四种不同的高血压管理策略的潜在长期影响.
- 评估SPRINT试验中符合条件的大量美国成年人中对心血管疾病事件和与治疗相关的不良事件的影响.
主要方法:
- 使用了经过验证的离散事件模拟模型 (血压控制-心血管疾病政策模型).
- 模拟了四种策略:高血压预防,检测,评估和治疗联合国家委员会 (JNC7) 常规护理第七次报告,SPRINT密集护理 (<120/90 mmHg),美国心脏病学会/美国心脏协会 (ACC/AHA) 常规护理 (<130/80 mmHg) 和团队护理 (<130/80 mmHg).
- 该模型拥有25,000名符合SPRINT资格的美国成年人,推断为1810万.
主要成果:
- 与JNC7常规护理相比,SPRINT重症监护每年可以预防大约138,100次心血管疾病事件.
- 每年,ACC/AHA常规护理和团队护理可以分别预防33900例和89100例心血管疾病事件.
- 预计SPRINT密集护理每年将严重不良事件增加77,600次;ACC/AHA常规护理增加33,300次;团队护理增加27,200次.
结论:
- 降低血压控制需要优先考虑高血压管理,并投资于有效的策略.
- 基于团队的护理,加上通常的护理,为高风险人群管理心血管疾病风险提供了一个务实的和有效的方法.
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