预测的心血管风险通过PREVENT方程在美国成年人的第一阶段高血压
Paul Muntner1, Byron C Jaeger2, Kathryn Foti1
1Department of Epidemiology, University of Alabama at Birmingham (P.M., K.F., L.G., L.C.).
Hypertension (Dallas, Tex. : 1979)
|July 15, 2024
概括
与较旧的聚合队列方程 (PCE) 相比,新的PREVENT方程显著降低了1阶段高血压的成年人10年预计动脉样性心血管疾病 (ASCVD) 风险. 这一发现影响了高血压治疗指南和对心血管疾病事件的风险评估.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 流行病学 流行病学
背景情况:
- 2017年ACC/AHA高血压指南建议使用聚合队列方程 (PCE) 治疗ASCVD风险≥10%的第一阶段高血压.
- 2023年PREVENT方程提供了对心血管疾病事件的最新风险估计.
研究的目的:
- 为了在患有第一阶段高血压的成年人中比较PREVENT和PCE方程之间的10年ASCVD风险估计.
- 评估新的PREVENT方程对心血管风险分层的影响.
主要方法:
- 分析了2013-2020年NHANES对1703名成年人 (30-79岁) 的数据,这些成年人患有第一阶段高血压并且没有先前的心血管疾病.
- 使用PCE估计10年ASCVD风险,使用PREVENT方程估计ASCVD和心血管疾病总风险.
- 权重分析以代表非机构化的美国成年人群.
主要成果:
- 与PCE (5.4%) 相比,PREVENT (2.9%) 的10年平均ASCVD风险明显低于PCE (5.4%).
- 当使用PREVENT方程 (0.3%) 与PCEs (15.9%) 时,具有高ASCVD风险的个体比例 (≥10%) 显著减少.
- 观察到一个显著的差异,在PCE中12.5%具有≥10%的ASCVD风险,但在PREVENT中<10%.
结论:
- 在美国,PREVENT方程估计,与PCE相比,ASCVD的10年风险大约为美国1期高血压成年人的一半.
- 这些发现表明,高血压管理的药物启动值可能发生变化.
- 需要进一步的研究来验证这些风险估计差异的临床影响.
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