根据ACC/AHAHA推的血压值,心血管事件发生
Gowsini Joseph1,2,3,4, Vi Thanh Pham5, Per Kragh Andersen5
1Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
Blood pressure
|July 17, 2024
概括
与正常血压相比,ACC/AHA对第一阶段高血压的定义并没有增加心血管风险. 然而,ESC/ESH定义确定了真正有心血管事件风险较高的个体.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 高血压研究 高血压研究
背景情况:
- 目前的高血压指南有所不同:ACC/AHA将第一阶段高血压定义为SBP 130-139 mmHg或DBP 80-89 mmHg.
- 在ESC/ESH指南中,高血压的定义是SBP≥140mmHg或DBP≥90mmHg.
- 关于未来心血管风险的ACC/AHA第一阶段高血压定义的临床意义仍在调查中.
研究的目的:
- 评估ACC/AHA对高血压的定义是否识别出患心血管疾病风险增加的个体.
- 根据ACC/AHA指南,比较与不同血压分类相关的心血管风险.
主要方法:
- 丹麦的一项前性心血管研究包括19721名参与者 (年龄在20-98岁),在1976年至2015年期间被检查了多达五次.
- 血压水平根据ACC/AHA指南进行分类:正常,高,第一阶段和第二阶段高血压.
- 计算了10年心血管事件风险,考虑了重复测量,共变量和竞争风险.
主要成果:
- 在第一阶段高血压 (14.1%) 中,心血管事件的10年风险与正常血压 (12.8%) (p=0.19) 中没有显著差异.
- 与正常,升高和第一阶段高血压 (p<0.001) 相比,第二阶段高血压的10年风险显著更高 (19.4%).
- 在第一阶段高血压中,10年心血管死亡风险 (6.6%) 与正常血压 (5.7%) (p=0.33) 并没有显著不同.
结论:
- 根据ACC/AHA指南,第一阶段高血压与正常血压相比,不会增加未来心血管事件的风险.
- 高血压的ESC/ESH定义有效地识别了患心血管事件风险增加的个体.
- 目前关于第一阶段高血压的ACC/AHA指南可能需要重新评估心血管结果的风险分层.
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