目标范围内的静脉血压时间与PRECISION参与者心血管事件的关联
Neel Agarwal1, Julie St John2, Vikas Sunder3
1Ohio State University College of Medicine, Columbus, Ohio, USA.
Journal of clinical hypertension (Greenwich, Conn.)
|July 8, 2025
概括
保持血压在目标范围内,称为目标范围内的时间 (TTR),与降低主要心血管不良事件 (MACE) 的风险有关. 在PRECISION试验中,较高的静脉血压TTR与更好的心血管结果相关.
科学领域:
- 心血管医学 心血管医学
- 临床试验 临床试验
- 高血压管理 高血压管理
背景情况:
- 血压 (BP) 是一个重要的标志,其特点是固有的变化.
- 评估BP变化和长期控制的新指标正在出现,例如目标范围内的时间 (TTR).
- TTR量化了患者的血压保持在预定义的治疗范围内的百分比时间.
研究的目的:
- 调查系统血压 (SBP) TTR和主要不良心血管事件 (MACE) 之间的关联.
- 在PRECISION试验队列中使用传统和Rosendaal线性插值 (RLI) 方法分析SBP TTR.
主要方法:
- 在PRECISION心血管结局试验中的20,487名参与者中分析SBP TTR.
- 根据SBP TTR对参与者的分类:<25%,25%-<50%,50%-<75%,和≥75%.
- 生成危险比率 (HR) 和卡普兰-梅尔生存曲线来评估MACE风险.
主要成果:
- 与<25%的TTR相比,在SBPTTR≥75%的参与者中观察到MACE的风险明显较低.
- 使用传统方法,对MACE的调整HR为0.70 (95% CI为0.52-0.95,p=0.02).
- 使用RLI方法,对MACE的调整HR为0.56 (95% CI为0.43-0.75,p<0.001).
结论:
- 目标范围内的较高静脉压时间与较大心血管不良事件的风险降低有关.
- TTR是评估长期血压控制和心血管风险的有价值指标.
- 这些发现支持实现和保持最佳血压控制以减轻心血管事件的重要性.
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