初始和持续正静止低血压中的心血管结果:一项回顾性队列研究
Hui Geng1, Dingfeng Fang1,2, Xiahuan Chen1
1Department of Geriatrics, Peking University First Hospital, Beijing, China.
Journal of clinical hypertension (Greenwich, Conn.)
|February 25, 2025
概括
静止性低血压 (OH) 会增加老年人的心血管风险. 最初的OH增加了主要不良心血管事件的风险,而持续的OH增加了心血管事件和死亡的风险.
科学领域:
- 老年医学 老年医学
- 心血管研究研究心血管研究
- 临床流行病学临床流行病学
背景情况:
- 静止性低血压 (OH) 是一种与心血管疾病相关的流行老年病.
- 关于初始与持续性OH的比较预后意义的数据有限.
- 了解这些区别对于老年人心血管风险评估至关重要.
研究的目的:
- 调查和比较与50岁及以上患者初始和持续的正静性低血压相关的心血管结果.
- 确定初始和持续OH对主要心血管不良事件 (MACE) 和全因死亡率的差异影响.
主要方法:
- 一项队列研究,包括435名年龄≥50岁的参与者.
- 使用CNAP监控器进行主动静态测试来诊断初始或持续的OH.
- 卡普兰-梅尔生存分析和多变量考克斯回归模型被用于对65个月的中位随访期的结果分析.
主要成果:
- 在435名参与者中,有94名 (21.6%) 患有初始 (43) 或持续 (51) 的脑膜炎.
- 主要结局 (MACE和死亡) 发生在159名 (36.6%) 患者中.
- 最初的OH显著增加了主要结果和MACE的风险 (HR分别为2.20和2.38),但并没有增加死亡率.
- 持续性OH显著增加了主要结局MACE (HR分别为1.77和1.71) 和死亡率 (HR 3.32) 的风险.
结论:
- 无论是初始的还是持续的正静性低血压都会增加年龄在50岁以上的患者的心血管风险.
- 特别是持续性OH,与死亡风险增加有关.
- 这些发现强调了区分OH类型对于老年人准确的心血管风险分层的重要性.
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