基于两个结局的日常血压变化的参考值建议:Ohasama研究
Michihiro Satoh1,2,3, Hirohito Metoki1,2,4, Masahiro Kikuya2,5
1Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.
Journal of hypertension
|July 8, 2024
概括
高家庭血压变化 (HSBP-CV) 增加了心血管死亡和认知衰退的风险. 建议在临床风险评估中为HSBP-CV提供约8.5%的一致参考值.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 家庭血压 (BP) 的变化对于评估高血压风险至关重要.
- 确定的高血压值需要与血压变异性保持一致,以预测不良结果.
- 这项研究重点关注心血管死亡率和认知能力下降风险.
研究的目的:
- 为日常家庭血压变化提出参考值.
- 将这些值与预测心血管死亡率和认知衰退的高血压值保持一致.
- 为风险分层建立临床参考标准.
主要方法:
- 在日本Ohasama的一项前性研究,涉及1212名心血管死亡率和678名认知衰退的参与者.
- 衡量家庭早晨缩血压 (HSBP) 的个体内变化系数 (CV),作为日复一日血压变化的指数.
- 使用调整后的考克斯回归模型来估计HSBP-CV值与10年结果风险相关,在家庭BP为135mmHg时.
主要成果:
- 在平均随访时间分别为13.9年和9.6年期间,确定了114例心血管死亡和85例认知衰退事件.
- 无论是HSBP还是HSBP-CV都与心血管死亡率 (HR≥1.25) 和认知能力下降 (HR≥1.30) 的风险增加显著相关.
- 当HSBP-CV大约为8.5%时,家庭静脉血压为135mmHg相当于心血管死亡率的1.67%和认知衰退的8.83%的10年风险,当HSBP-CV大约为8.5%时.
结论:
- 家庭血压变化 (HSBP-CV) 的参考值表明,在家庭缩血压为135mmHg的情况下,10年风险在心血管死亡率和认知衰退方面一致,约为8.5%.
- 这种建议的HSBP-CV参考值对于临床风险分层有价值.
- 进一步的研究可能会完善这些个性化风险评估门.
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