最佳抗高血压静脉压血压:一个系统性审查和元分析
Paul K Whelton1,2, Samantha O'Connell1, Katherine T Mills1
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (P.K.W., S.O.C., K.T.M., J.H.).
Hypertension (Dallas, Tex. : 1979)
|September 12, 2024
概括
降低系统血压 (SBP) 至130 mmHg以下,可显著降低心血管疾病 (CVD) 和死亡风险. 低于120mmHg的SBP目标也显示出好处,尽管不良事件略有增加.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 公共卫生 公共卫生
背景情况:
- 经证实,降低系统血压 (SBP) 可以减少心血管疾病 (CVD) 和死亡率.
- 最佳的SBP干预目标仍然是正在进行的辩论和研究的主题.
研究的目的:
- 评估SBP目标<130 mmHg与≥130 mmHg在降低心血管疾病和全因死亡率方面的有效性.
- 进行二次分析,比较SBP目标<120 mmHg与<140 mmHg相同的结果.
主要方法:
- 七项随机对照试验的元分析,涉及72,138名参与者.
- 使用标准化协议进行数据提取,并进行独立的重复审查.
- 随机效应模型用于计算聚合危险比率 (HRs) 和95%置信区间 (CI).
主要成果:
- 与≥130 mmHg相比,SBP目标<130 mmHg显著降低了主要心血管疾病 (HR,0.78) 和全因死亡率 (HR,0.89).
- 与<140 mmHg相比,强度SBP目标<120 mmHg显著降低了主要心血管疾病 (HR,0.82),并非显著降低了全因死亡率.
- 强烈的SBP目标与更高的不良事件发生率有关,尽管绝对风险仍然很低.
结论:
- 准SBP<130 mmHg可显著降低主要心血管疾病和全因死亡率.
- 有证据支持考虑SBP目标<120 mmHg,特别是在特定患者群体中,同时监测不良事件.
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