手臂和脚血压指数,外围动脉疾病和死亡率:一个队列研究
Kamel Mohammedi1,2, Marie Pigeyre1, Jackie Bosch1,3
1Population Health Research Institute, McMaster University, 237 Barton St. E, Hamilton, ON, Canada L8L 2X2.
European heart journal
|March 1, 2024
概括
关节血压测量,包括关节缩血压和关节脉冲压差,与手臂血压测量相比,是外围动脉疾病和死亡率的优越预测指标. 这些发现强调了脚BP在心血管风险评估中的重要性.
科学领域:
- 心血管医学 心血管医学
- 血管健康 血管健康
- 流行病学 流行病学
背景情况:
- 有限的研究存在,比较与周围动脉疾病 (PAD) 和死亡率相关的手臂和脚血压 (BPs).
- 这项研究利用了三项大型前性临床试验的数据来解决这一知识差距.
研究的目的:
- 评估手臂和脚血压指数在预测事件PAD和全因死亡率方面的比较价值.
- 为了确定哪些BP测量提供了最准确的PAD和死亡率风险分层.
主要方法:
- 使用的基线血压指数包括缩血压 (SBP),腹缩血压 (DBP),脉冲压,脚SBP,脚-手臂指数 (ABI) 和脚-脉冲压差 (APPD).
- 将血压测量分类为四分位数,并分析它们与PAD发展,PAD或死亡复合和5年内所有原因死亡的关联.
- 采用统计模型来比较不同BP指数的预测性能,包括c-统计和分类指数.
主要成果:
- 在一个没有PAD基线的40,747名参与者的队列中,较高的手臂血压指数与增加的PAD风险相关,而较高的脚血压指数显示出保护性关联.
- 脚BP指数,特别是脚SBP和APPD,显示出与事件PAD和死亡率的最强的关系.
- 脚血压指数为未来的PAD提供了优越的预测准确度,与已确定的风险因素相比,性能优于手臂血压测量.
结论:
- 脚BP指数,特别是脚SBP和APPD,是对外围动脉疾病和死亡率最有效的预测指标.
- 常规测量脚血压可以提高心血管风险评估和PAD的患者管理.
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