在患有或没有糖尿病的患者中,时间加权的血压与心血管风险
Zhixin Jiang1, Fang Shao2, Jingwen Hu1
1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Clinical cardiology
|January 25, 2024
概括
时间加权血压,考虑大小和持续时间,独立预测糖尿病或没有糖尿病的患者的心血管事件. 这种新型指标提供了比传统措施更全面的风险评估.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 临床试验分析 临床试验分析
背景情况:
- 传统的血压 (BP) 测量不能捕捉高血压随时间的累积影响.
- 评估心血管风险需要考虑高血压的强度和持续时间的方法.
研究的目的:
- 评估一种新的时间加权血压指标与心血管结果之间的关联.
- 为了证明时间加权BP的预测价值在不同的患者群体,包括那些有和没有糖尿病.
主要方法:
- 对来自ACCORD和SPRINT随机对照试验的数据进行了后期分析.
- 时间加权BP的计算方法是将累积BP除以后续总时间.
- 在高血压值以上的时间加权BP负荷的确定 (例如,>130/80 mmHg和>140/90 mmHg).
主要成果:
- 在时间加权BP和主要不良心血管事件 (MACE) 之间观察到J曲线关系.
- 时间加权的静缩血压 (SBP) 和静缩血压 (DBP) 负担独立地预测了跨试验和值的MACE.
- 在中风,心肌梗塞,心血管死亡和全因死亡率方面发现了显著的关联.
结论:
- 时间加权的血压,包括SBP和DBP,是不良心血管事件的独立预测因素.
- 这一指标为患有和没有糖尿病的患者提供了有价值的风险分层,无论使用的高血压定义如何.
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