在个性化抗高血压治疗中遗传风险和冠状动脉:一个聚合队列分析
Naman S Shetty1, Mokshad Gaonkar2, Akhil Pampana1
1Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham.
Mayo Clinic proceedings
|August 8, 2024
概括
系统性血压多原风险评分 (SBP-PRS) 对高血压患者开始抗高血压治疗具有适度的价值. 遗传风险和冠状动脉 (CAC) 评分都有助于个性化高血压治疗.
科学领域:
- 心血管医学 心血管医学
- 遗传学 遗传学 是一个
- 预防性心脏病学 预防性心脏病学
背景情况:
- 风险分层对于指导开始抗高血压治疗至关重要.
- 目前的风险评估工具可能无法完全捕捉个体对心血管疾病 (CVD) 的敏感性.
- 多基因风险评分 (PRS) 和冠状动脉 (CAC) 评分是个性化风险评估的新兴工具.
研究的目的:
- 评估系统血压多原风险评分 (SBP-PRS) 在抗高血压治疗决策中的有用性.
- 为了比较SBP-PRS与冠状动脉 (CAC) 评分在风险分层中的有效性.
- 评估SBP-PRS在为高血压患者个性化抗高血压治疗中的作用.
主要方法:
- 对5267名参与者的回顾性队列研究,包括全基因组测序和CAC扫描.
- 参与者没有普遍的心血管疾病,也没有服用抗高血压药物.
- 由SBP-PRS (低/中等与高) 和CAC得分 (0与>0) 分层化的队列,以估计对主要结果 (冠心病,心力衰竭,中风) 的10年治疗需要的数量 (NNT).
主要成果:
- 在1317名高血压/低风险第一阶段高血压患者中,10年初级结局发生率为5.6% (低/中等SBP-PRS,NNT=63) 与6.3% (高SBP-PRS,NNT=59) 相比.
- 对于CAC分数,10年发生率为2.9% (CAC=0,NNT=117) 与9.7% (CAC>0,NNT=37) 相比.
- 无论是SBP-PRS还是CAC分数,都显示了对主要结果的不同程度的风险分层.
结论:
- 通过SBP-PRS的遗传信息,在高血压/低风险第一阶段高血压患者的抗高血压治疗中提供了适度的价值.
- 遗传风险 (SBP-PRS) 和CAC分数都有效地个性化抗高血压治疗策略.
- 这些发现支持将遗传和成像生物标志物的整合用于定制的心血管风险管理.
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