在糖尿病和非糖尿病高风险高血压患者中,与脏保护相关的低收缩性血压
Eirik Olsen1,2, Camilla L Søraas3,4, Roland E Schmieder5
1The Norwegian University of Science and Technology, Trondheim, Norway.
American journal of hypertension
|May 21, 2025
概括
在高风险高血压患者中,降低缩血压 (SBP) 到130-139 mmHg可以保护脏. 即使较低的SBP目标 (<130 mmHg) 也可以提供额外的脏益处,无论糖尿病状况如何.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 高血压管理 高血压管理
背景情况:
- 降低缩血压 (SBP) 在保护高血压患者脏的作用仍在争论中.
- 这项研究研究了在中年和老年高风险高血压患者中达到较低SBP的脏保护作用,有或没有2型糖尿病.
研究的目的:
- 确定多年来实现较低的平均SBP是否能在高风险高血压患者中提供脏保护.
- 澄清不同SBP目标对功能和末期病 (ESKD) 风险的影响.
主要方法:
- 对13,803名高血压患者 (50-80岁) 的分析,随机分配给瓦尔萨坦或阿姆洛迪平.
- 基于达到的SBP水平 (<130 mmHg,130-139 mmHg和≥140 mmHg) 的恶化功能 (50%的血清肌素或ESKD升高) 的比较.
- 调整后的考克斯分析用于比较2型糖尿病患者和没有2型糖尿病患者的结局.
主要成果:
- 与SBP≥140 mmHg患者相比,达到SBP130-139 mmHg或<130 mmHg的DM患者的功能恶化明显较小.
- 较低的SBP目标与DM患者末期病 (ESKD) 风险降低有关.
- 在没有DM的患者中观察到类似的脏保护趋势,这表明跨组的益处一致.
结论:
- 针对130-139mmHg的SBP在50-80岁的高风险高血压患者中提供显著的脏保护,无论是否患有糖尿病.
- 达到SBP<130 mmHg可能提供进一步的脏保护益处.
- 这些发现支持加强血压管理,以此患者群体的脏保护.
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