在患有外周动脉疾病的患者中治疗动脉高血压
Pavel Poredoš1, Dimitri P Mikhailidis2,3, Kosmas I Paraskevas4
1Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
高血压显著增加了外围动脉疾病 (PAD) 和心血管事件的风险. 对PAD患者的最佳血压目标可能有所不同,因为非常低的静脉压 (<120 mmHg) 可能会使结果恶化.
科学领域:
- 心血管医学 心血管医学
- 血管生物学 血管生物学
- 高血压研究 高血压研究
背景情况:
- 高血压是外围动脉动脉样硬化疾病 (PAD) 的主要危险因素,对动脉壁结构和功能产生负面影响.
- 血压升高有助于内皮功能障碍,光滑肌肉细胞增生和动脉重塑,增加周围阻力和动脉样硬化.
- 高血压,特别是随着脂质失调,加快了各种血管床的动脉样硬化,特别是下肢.
研究的目的:
- 检查高血压管理和外围动脉疾病 (PAD) 患者的结果之间的复杂关系.
- 评估特定血压目标对PAD患者心血管和四肢相关事件的影响.
- 评估不同类型的抗高血压药物在PAD人群中高血压管理中的作用.
主要方法:
- 对PAD中高血压管理现有文献和临床指南的审查.
- 在PAD患者中分析了系统血压 (SBP) 水平和心血管 (CV) 事件之间的关联.
- 考虑抗高血压药物,包括ACE抑制剂,对PAD输液和结果的影响.
主要成果:
- 高血压与心血管事件和PAD进展的风险增加有关.
- 在SBP和初级结果之间存在J形关系,表明SBP<120 mmHg可能与不良事件有关.
- ACE 抑制剂可能为 PAD 患者的腿部输液提供额外的益处,包括患有关键四肢缺血症的患者.
结论:
- 对患有PAD的患者来说,高血压的治疗对于降低心血管事件风险至关重要.
- 然而,达到非常低的血压目标 (SBP <120 mmHg,DBP <70 mmHg) 可能会导致肢体和心血管不良结果.
- 患有PAD的患者可能需要与没有PAD的患者不同的个性化血压目标,以优化整体健康和四肢挽救.
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