抗性高血压和死亡率:一个观察性队列研究
Alejandro de la Sierra1, Luis M Ruilope2, Natalie Staplin3
1Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Terrassa, Spain (A.d.l.S.).
Hypertension (Dallas, Tex. : 1979)
|September 9, 2024
概括
抗性高血压,特别是当通过门诊血压监测 (ABPM) 确认时,与控制高血压相比,显著增加了全因和心血管死亡的风险.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 临床结果 临床结果
背景情况:
- 耐性高血压 (RH) 被定义为高血压 (BP),尽管有三种抗高血压剂.
- 门诊血压监测 (ABPM) 可以区分真正的RH和白袍RH.
- 在ABPM确认的RH与白衣RH的预后影响需要进一步澄清.
研究的目的:
- 为了比较控制高血压和耐药高血压患者之间的全因和心血管死亡风险.
- 评估ABPM确认的耐药高血压和白衣耐药高血压之间的死亡风险差异.
主要方法:
- 一项队列研究涉及8146名控制高血压患者和8577名耐药高血压患者.
- 患者被分为白衣RH (n=3289) 和ABPM确认的RH (n=5288) 组.
- 考克斯模型被用来比较所有原因和心血管死亡率,经过对混因子进行调整,平均随访时间为9.7年.
主要成果:
- 抗性高血压与控制高血压相比,与所有原因 (HR 1.21) 和心血管死亡率 (HR 1.33) 的增加有关.
- 与白衣RH相比,ABPM确认的RH显示所有原因 (HR 1.45) 和心血管死亡率 (HR 1.68) 的风险更高.
- 只有ABPM确认的RH,而不是白衣RH,与控制的高血压相比,与死亡率显著增加有关.
结论:
- 经ABPM确认的抗性高血压与白衣抗性高血压相比,死亡风险明显更高.
- 使用ABPM准确诊断耐药高血压对于风险分层和管理至关重要.
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