通过心血管风险密集血压控制的益处和危害
Xilan Dong1, Qianhui Ling2, Xueyan Zhao3
1Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.D., Q.S.).
Hypertension (Dallas, Tex. : 1979)
|June 26, 2025
概括
密集的血压控制为高风险患者提供了更大的心血管益处,即使危害增加. 密集治疗的整体益处超过了所有心血管疾病风险水平的危害.
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:
- 目前的血压治疗指南根据心血管疾病 (CVD) 风险分层治疗.
- 心血管疾病风险对密集血压控制的益处和危害的具体影响尚不清楚.
研究的目的:
- 评估密集血压控制对心血管的益处和与治疗相关的不良事件.
- 为了在不同水平的心血管疾病风险中评估这些结果.
主要方法:
- 分析了8262名来自STEP试验的患者,根据基线10年心血管疾病风险分层.
- 利用Cox比例危险和Poisson回归模型来分析结果事件并预测好处/危害.
主要成果:
- 强化治疗降低了所有风险三分动物的初级结果 (整体HR,0.76).
- 随着强化治疗,不良事件略有增加 (HR,1.1).
- 更高的心血管疾病风险与更大的绝对风险降低和不良事件增加相关.
结论:
- 心血管疾病风险增加与密集血压控制带来的益处和危害更大.
- 尽管益处-危害概况的差异不同,但密集控制在所有风险三地动物中显示出整体益处.
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