在评估心血管风险时,开发和验证中央血压的诊断值
Shuqi Wang1, Samuel Y S Wong1, Benjamin H K Yip1
1JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, JC School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
European journal of preventive cardiology
|May 23, 2025
概括
一个新的中央血压 (cBP) 的门被确定为135mmHg. 中枢高血压,即使没有手臂高血压,也会显著增加心血管疾病 (CVD) 风险,比传统措施更好地预测风险.
科学领域:
- 心脏病学 心脏病学
- 高血压研究 高血压研究
- 预防医学 预防医学
背景情况:
- 传统的血压 (BP) 测量可能无法完全捕捉心血管疾病 (CVD) 风险.
- 中心血压 (cBP) 可以更直接地评估动脉负载.
- 确定cBP的结果衍生值对于临床应用至关重要.
研究的目的:
- 为了确定中心血压 (cBP) 的结果衍生值.
- 评估cBP在心血管疾病 (CVD) 风险分层中的临床实用性.
- 为了比较与不同组合的手臂和中心血压水平相关的心血管疾病风险.
主要方法:
- 来自英国生物库的34,289名成年人的回顾性队列研究.
- 主要终点:心血管死亡率和非致命心血管事件的组合.
- 使用引导和近似方法开发了cBP诊断值;用于风险预测分析使用了Cox回归.
主要成果:
- 确定了135mmHg的中央缩血压 (SBP) 值,这与140mmHg的手臂缩血压值相对应.
- 确定了不同的风险类别:一致的正常血压 (49.84%),孤立的手臂高血压 (2.23%),孤立的中心高血压 (3.65%),和一致的高血压 (44.28%).
- 与正常血压相比,孤立的中央高血压 (HR 1.70) 和一致的高血压 (HR 1.51) 显示心血管疾病风险明显增加. 包括cBP改善了心血管疾病风险预测模型.
结论:
- 建议SBP的中心诊断值为135 mmHg.
- 升高的中心高血压意味着心血管疾病风险增加,不管手臂血压状况如何.
- 整合中央血压测量可以提高心血管风险预测,超出传统的手臂血压评估.
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