使用审查数据方法来估计美国成年人的血压百分值
Bernard Rosner1,2, Nancy R Cook3,4, Robert J Glynn2,3
1Channing Division of Network Medicine Harvard Medical School.
American journal of epidemiology
|September 17, 2024
概括
在服用药物的成年人中估计潜在的血压 (BP) 对心血管疾病 (CVD) 风险评估至关重要. 一种新方法揭示了药物效应因年龄,BMI和种族而异,改善了风险预测.
科学领域:
- 心血管健康 心血管健康
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 血压 (BP) 是心血管疾病 (CVD) 的一个关键可修改的风险因素.
- 抗高血压药物 (MEDS) 降低了观察到的血压,但是较高心血管疾病风险的标志物.
- 准确估计潜在的血压 (不使用药物的血压) 对于精确的风险评估至关重要.
研究的目的:
- 提出和验证一种新的时间到事件方法来估计潜在的BP.
- 量化抗高血压药物对血压的治疗效果.
- 为了获得基础血压的最新,年龄性别特定的血压百分位数.
主要方法:
- 使用时间到事件分析,将MEDS上的BP测量作为受审查的数据.
- 将该方法应用于美国成年人代表性样本 (NHANES 1999-2018).
- 计算了治疗效果的中位数,并根据年龄,BMI和种族分析了修改.
主要成果:
- 治疗效果中位数 (基础血压 - 观察血压) 在男性的SBP/DBP中为12.0/7.7 mm Hg,在女性中为16.9/6.5 mm Hg.
- 治疗效果因年龄,体重指数 (BMI) 和黑人种族而显著改变.
- 导出了基于年龄和性别的百分比图表,用于基本的BP.
结论:
- 新的时间到事件方法提供了与固定增量相比,更准确地估计了潜在的BP.
- 底层的BP估计及其衍生百分位数为心血管疾病风险分层提供了改进的工具.
- 调查结果强调需要个性化风险评估,考虑药物效应和个人因素.
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