在患有高血压和高心血管风险的成年人中,强化血压降低疗法与标准血压降低疗法相比,减少了主要血管事件
1Charles R. Drew University & David Geffen School of Medicine at UCLA, Los Angeles, California, USA (M.B.D.).
Annals of internal medicine
|September 30, 2024
概括
在高风险患者中,将血压降低到120mmHg以下的强化血压显著减少了心血管事件. 这种密集的缩血压管理证明对患有或没有糖尿病或以前中风的个人有益.
科学领域:
- 心血管医学 心血管医学
- 临床试验 临床试验
- 高血压管理 高血压管理
背景情况:
- 高心血管风险需要有效的血压管理策略.
- 之前的指导方针建议不同的系统血压目标,为高风险人群创造不确定性.
- 预防主要心血管不良事件 (MACE) 的最佳静脉压值仍然是一个关键的临床问题.
研究的目的:
- 为了比较密集缩血压降低 (目标<120 mm Hg) 与标准降低 (目标<140 mm Hg) 在心血管事件高风险的患者中的疗效.
- 评估在子组中密集血压管理的益处,包括糖尿病患者或中风病史患者.
主要方法:
- 一个开放标签,随机对照试验,涉及高心血管风险的患者.
- 盲目评估结果以尽量减少偏见.
- 随机分配到密集的系统血压目标 (<120 mm Hg) 或标准目标 (<140 mm Hg).
主要成果:
- 与标准策略相比,强化降血压策略显著降低了主要心血管事件的发生率.
- 在各种子组中观察到好处,包括糖尿病患者和以前中风患者.
- 在密集治疗组中没有发现严重不良事件的显著增加.
结论:
- 降低缩血压到低于120毫米柱的比降低到低于140毫米柱的更好,以预防高风险个体的心血管事件.
- 这种密集的血压管理策略对于患有高心血管风险的患者来说是安全有效的,无论糖尿病或之前的中风状况如何.
- 这些发现支持在选择的高风险人群中更积极的血压目标,以改善心血管结果.
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