基线风险和结果从密集的血压准中受益. 一个系统的审查
Paolo Verdecchia1, Fabio Angeli2, Gianpaolo Reboldi3
1Associazione Umbra Cuore e Ipertensione and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy.
European journal of internal medicine
|July 17, 2025
概括
达到低于120mmHg的缩血压目标可以显著降低心血管和全因死亡率. 密集血压控制的好处对于基线风险较高的人来说更大.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 公共卫生 公共卫生
背景情况:
- 最近的随机临床试验 (RCT) 建议比以前推的更低的系统血压 (BP) 目标.
- 基线风险对密集BP准的好处的影响需要进一步调查.
研究的目的:
- 调查基线风险对强化血压准所产生的结果效益的影响.
- 分析不同密集的缩血压对心血管和全因死亡率的有效性.
主要方法:
- 一个系统的审查和11个随机临床试验 (RCTs) 的元分析,涉及63,090名患者.
- 试验的分类是基于缩血压目标:<120 mmHg (紧张) 和<125-140 mmHg (不那么紧张).
- 主要结局包括心血管死亡和全因死亡;次要结局是中风,心力衰竭和心肌梗塞.
主要成果:
- 缩血压目标<120 mmHg显著降低了心血管死亡 (RD -4.61) 和所有原因死亡 (RD -5.23).
- 不太强烈的目标 (<125-140 mmHg) 没有显示出心血管或全因死亡的显著减少.
- 在更高的基线风险 (在对照组) 和强化血压控制的更大益处之间观察到正相关性.
结论:
- 静心血压目标<120 mmHg始终降低所有原因和心血管死亡率.
- 从密集的血压准中获益的幅度随着基线个体风险较高而增加.
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