静脉血压目标低于120mm Hg与死亡率降低有关:一个元分析
Felix Bergmann1, Marlene Prager1, Lena Pracher1
1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Journal of internal medicine
|March 5, 2025
概括
在高风险患者中,密集的静脉压控制 (<120 mmHg) 降低了死亡率和主要心血管不良事件 (MACE). 然而,它增加了不良事件的风险,如低血压和急性损伤.
科学领域:
- 心脏病学 心脏病学
- 高血压管理 高血压管理
- 临床试验 临床试验
背景情况:
- 对于心血管风险较高的人来说,最佳静脉压 (SBP) 目标尚未确定.
- 关于密集与标准SBP控制策略的好处和风险存在不确定性.
研究的目的:
- 与标准SBP控制 (<140 mmHg) 相比,评估密集SBP控制 (<120 mmHg) 的有效性和安全性.
- 评估对死亡率,主要心血管不良事件 (MACE) 和高风险人群的特定安全结果的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索的主要数据库 (PubMed,Embase,科学网,科克兰图书馆) 截至2024年11月.
- 包括比较强化 (<120 mmHg) 与标准 (<140 mmHg) SBP控制在高心血管风险成年人的研究.
主要成果:
- 分析了5个RCT,其中包括39,434名患者.
- 密集的SBP控制显著降低了所有原因死亡率 (RR 0.87;P=0.03) 和MACE.
- 密集控制也减少了心血管死亡,中风,心肌梗塞和心力衰竭,但增加了低血压,昏和急性损伤的风险.
结论:
- 在高风险患者中准SBP<120 mmHg可降低全因死亡率和MACE.
- 这种密集的策略与更高的不良事件发生率有关,包括低血压和电解质异常.
- 这些发现表明,在密集的SBP控制下,心血管益处和安全问题之间进行了权衡.
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