目标血压时间及其对心血管结果的预后价值:范围审查
Wansha Li1, Sonali R Gnanenthiran2,3, Aletta E Schutte1,3
1School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
概括
血压治疗范围中的时间 (BP-TTR) 是高血压管理的有价值指标. 较高的BP-TTR始终与较低的心血管事件风险相关,无论使用的计算方法如何.
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:
- 血压 (BP) 目标时间,或治疗范围内的时间 (BP-TTR),是评估高血压控制的新兴指标.
- 目前用于确定BP-TTR的方法在研究中差异很大,阻碍了一致的解释和应用.
- 了解这些变化和BP-TTR的预后价值对于有效的心血管风险评估至关重要.
研究的目的:
- 系统地审查和识别用于确定BP-TTR的方法的变化.
- 评估BP-TTR对心血管结果的潜在预后价值.
- 为标准化BP-TTR测定提供建议.
主要方法:
- 在PRISMA扩展后,在Embase,PubMed,Scopus,Web of Science和CINAHL进行了系统的文献搜索.
- 包括的研究包括临床试验,观察性研究,队列研究,横截面研究和以英语出版的系统综述.
- 从最初的369篇文章中,包括了17篇文章,分析了BP目标,测量持续时间和计算方法的差异.
主要成果:
- 在BP目标 (例如,<140/90 mmHg与130/80 mmHg),测量持续时间 (24小时至15年) 和计算方法 (线性插值与读数比例) 中观察到显著的异质性.
- 尽管有方法差异,但更高的BP-TTR始终与心血管结局风险降低有关.
- 在大多数研究中,即使独立于平均达到的BP或最后测量的BP,这种关联仍然显著.
结论:
- BP-TTR对心血管结果具有显著的预后价值,可能超过目前的BP控制措施.
- 建议对BP-TTR测定方法进行标准化,以提高可比性和临床实用性.
- 对于稀疏的BP数据,建议偏好线性插值方法,而对于丰富的数据,比例读数方法是合适的.
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