治疗后血压作为5年中风预测模型中的关键预测因素
Nan Zhang1, Jiarong Mei1, Fangfang Fan1
1Department of Cardiology, Peking University First Hospital, Beijing, China.
Journal of clinical hypertension (Greenwich, Conn.)
|January 17, 2025
概括
高血压显著增加了中风风险. 针对高血压患者的新5年中风预测模型强调了长期血压控制是预防中风的关键因素.
科学领域:
- 心血管医学 心血管医学
- 流行病学 流行病学
- 预防性心脏病学 预防性心脏病学
背景情况:
- 高血压在中风幸存者中非常普遍,影响63.0%-84.2%.
- 现有的中风预测工具并不专门针对高血压患者.
- 对这一群体进行量身定制的中风风险评估至关重要.
研究的目的:
- 开发和验证高血压患者的5年中风风险预测模型.
- 确定高血压患者中风的关键预测因素.
- 为临床医生和患者提供评估和管理中风风险的工具.
主要方法:
- 利用了中国中风初级预防试验 (CSPPT) 中20702名高血压患者的数据.
- 在研究期间,每3个月收集处理过的血压测量.
- 采用引导重新抽样进行内部验证,并使用C指数和校准曲线评估预测性能.
- 开发了一个随机森林模型来确定变量重要性.
主要成果:
- 5年中风风险预测模型包括10个关键风险因素.
- 发现的最重要的预测因素是治疗期间的平均静缩血压,年龄和治疗期间的平均静缩血压.
- 其他重要因素包括基线血压,糖尿病史,胆固醇,叶酸水平,压力,吸烟和叶酸补充.
- 该模型实现了0.74的C统计,具有良好的内部一致性.
结论:
- 长期治疗后的血压是高血压患者中风风险的主要预测因素.
- 开发的模型和在线计算器为此群体中风风险评估和预防提供了有价值的工具.
- 这项研究强调了持续血压管理对于高血压患者中风预防的重要性.
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