青少年的高血压和早期的中风
Boris Fishman1,2,3,4, Adi Vinograd5, Avishai M Tsur2,3,6,7,8
1Division of Cardiology, Sheba Medical Center, Ramat Gan, Israel.
NEJM evidence
|November 17, 2024
概括
青少年腹筋血压升高 (DBP) 与年轻成年人中风风险增加有关. 即使在女性中略微升高的DBP (70-79 mmHg) 也会增加中风风险,这突显出需要针对性别的BP指导方针.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 公共卫生 公共卫生
背景情况:
- 在年轻人中,中风的发病率正在上升,部分原因是缺乏诊断的风险因素.
- 目前青少年血压 (BP) 准则缺乏性别特异性和基于结果的证据.
研究的目的:
- 研究青少年血压与长期中风风险之间的关联.
- 确定是否需要性别特定的血压值来预测年轻成人中风.
主要方法:
- 在全国范围内,基于人口的回顾性队列研究1,897,048以色列青少年 (1985-2013).
- 主要结局:首次中风事件 (缺血或出血) 到52岁,使用以色列国家中风注册表.
- 考克斯的比例危险模型按性别分层,调整为共变量.
主要成果:
- 在男性中,青少年DBP≥80 mmHg与中风风险增加有关 (aHR1.28).
- 在女性中,青少年DBP≥80 mmHg (aHR1.38) 和70-79 mmHg (aHR1.41) 与中风风险增加有关.
- 青少年心血压升高 (≥120 mmHg) 与中风风险没有关联.
结论:
- 青少年透气血压≥80mmHg是年轻成年人中风的重要危险因素.
- 在青春期心血压升高似乎不是中风风险因素.
- 研究结果表明,有必要对青少年进行性别特异的血压监测和风险评估.
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