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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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根据循环血压的死亡率,在高血压患者中,脏功能正常或受损的患者的死亡率
Manuel Gorostidi1, Michael Böhm2, Luis M Ruilope3
1Department of Nephrology, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain.
概括
慢性病 (CKD) 患者的高血压增加了死亡风险. 门诊血压监测 (ABPM) 比临床血压更好地预测死亡风险,特别是在功能受损的人中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 高血压研究 高血压研究
背景情况:
- 高血压是慢性病 (CKD) 死亡的主要风险因素.
- 了解血压 (BP) 和死亡率之间的关系对于管理CKD患者至关重要.
- 门诊血压监测 (ABPM) 与临床测量相比,提供了更全面的血压评估.
研究的目的:
- 评估 ambulatory BP 与高血压患者和功能变化的高血压患者的总和心血管死亡率的相关性.
- 为了比较门诊BP与临床BP在CKD患者死亡率方面的预测值.
主要方法:
- 利用了来自西班牙ABPM注册表的数据,包括34,006名高血压患者的估计球过率 (eGFR) 数据.
- 采用完全调整的考克斯模型来评估BP测量和死亡结果之间的关联.
- 根据正常或减少的eGFR (<60毫升/分钟/1.73米2) 分析了各个子组的死亡风险.
主要成果:
- 较高的24小时,白天和夜间缩血压与增加的总死亡率有关.
- 临床缩血压显示了与死亡率的U形关联.
- 较低的门诊性缩血压 (<120 mmHg) 与死亡风险降低有关,特别是在功能受损的患者中.
结论:
- 门诊BP监测比临床BP更具信息性,用于预测功能受损患者的死亡风险.
- 降低门诊血压水平与慢性病患者的死亡率降低有关.
- 这些发现强调了ABPM对高血压CKD患者风险分层和风险管理的重要性.
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