使用"现实世界"诊所血压的绝对心血管风险评估与标准化的未观察和门诊方法相比:一项观察性研究
Niamh Chapman1,2, Senali Jayasinghe3, Myles N Moore3
1Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia. Niamh.Chapman@Sydney.edu.au.
概括
与标准化方法相比,现实世界诊所血压 (BP) 测量高估了心血管疾病 (CVD) 风险. 更准确的血压监测对于可靠的心血管疾病风险评估至关重要.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 临床测量 临床测量
背景情况:
- 临床血压 (BP) 是心血管疾病 (CVD) 风险评估的标准.
- 在现实世界的诊所中,血压测量通常没有标准化,并且不如严格的方法可靠.
- 非标准化的临床BP对心血管疾病风险评估的影响尚不清楚.
研究的目的:
- 为了比较使用现实世界诊所BP与标准化BP测量技术的绝对CVD风险评估.
- 根据BP测量方法量化CVD风险分类中的差异.
主要方法:
- 患有高血压的患者使用现实世界诊所BP,无观察自动化办公室BP (AOBP) 和24小时门诊BP监测 (ABPM) 进行了BP评估.
- 绝对心血管疾病风险是根据每个方法的缩血压计算的弗雷明汉风险评分来计算的.
- 风险分类之间的一致性使用卡帕统计数据进行评估.
主要成果:
- 临床血压明显高于AOBP和ABPM (18-22mmHg高).
- 使用临床BP的绝对心血管疾病风险得分更高,将40%的参与者归类为高风险,而AOBP/ABPM的17-20%.
- 临床BP和标准化方法之间的风险分类协议较弱 (卡帕值为0.52-0.57).
结论:
- 与AOBP和ABPM相比,非标准化的"现实世界"诊所BP测量导致CVD风险得分更高和风险错误分类.
- 这些发现突出了心血管疾病风险评估中的重大差异,原因是BP测量变化.
- 对于临床实践中准确的绝对心血管疾病风险评估,需要更严格的血压测量方法.
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