多重危险因素控制水平对高血压患者心血管结果的影响
Xinyi Peng1, Miaomiao Zhuang1, Qirui Song1
1Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing 100037, China.
概括
在高血压患者中控制更多的心血管风险因素可以显著降低心血管事件和死亡的风险. 综合性风险因素管理对于降低心血管疾病风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 高血压管理 高血压管理
- 预防医学 预防医学
背景情况:
- 基线风险因素控制对接受血压干预的高血压患者心血管结果的影响尚不清楚.
- 在使用降血压策略的高血压患者中,基线风险因子控制和心血管结果之间的关联需要进一步研究.
研究的目的:
- 研究高血压患者基线风险因素控制水平与心血管结果之间的关系.
- 为了确定基线风险因素控制是否与接受降血压治疗的高血压患者的心血管结果有关.
主要方法:
- 针对老年高血压患者血压干预策略 (STEP) 试验的数据分析.
- 排除缺乏完整基线风险因素数据的参与者.
- 利用Cox比例危险模型来评估风险因素控制水平 (≥6,5,4,≤3) 与心血管结果 (心血管事件和所有原因死亡率的组合) 之间的关联.
主要成果:
- 分析包括8337名参与者,随访时间中位数为3.19年.
- 每一个额外的不受控制的风险因素都会使心血管风险增加24% (HR 1.24,95% CI 1.11-1.37).
- 与最佳控制 (HR 1.95,95% CI 1.37-2.77) 患者相比,控制风险因素≤3的患者心血管风险高95% (HR 1.95,95% CI 1.37-2.77).
结论:
- 在高血压患者中,心血管风险和可控制的风险因素的数量之间存在着明确的,逐步的关联.
- 强化修改多种风险因素可以降低心血管风险,而不依赖于抗高血压治疗的强度.
- 综合风险因素控制策略对于减轻高血压患者心血管疾病风险至关重要.
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