强化血压控制对虚弱患者的影响:来自ESPRIT的后期分析
Shitian Li1, Yue Peng1, Yan Li1
1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Disease, Beijing, China.
Journal of the American College of Cardiology
|October 15, 2025
概括
密集的血压控制有利于高风险的高血压患者,无论他们的脆弱性如何. 密集治疗策略在ESPRIT试验中显示出对主要心血管不良事件和不良事件在所有脆弱程度的不良事件产生一致的影响.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 临床试验 临床试验
背景情况:
- 关于强化血压 (BP) 控制对脆弱个体的益处和危害的证据有限.
- 脆弱性评估对于定制心血管风险管理策略至关重要.
研究的目的:
- 分析基于ESPRIT试验中的脆弱性状态的密集血压控制的益处危害概况.
- 调查不同程度的脆弱性治疗效果的异质性.
主要方法:
- 对ESPRIT试验数据的后期分析.
- 用洛克伍德累积赤字方法 (脆弱指数) 将参与者分为非脆弱,中度脆弱和严重脆弱.
- 研究了强化降血压治疗对主要心血管不良事件 (MACE),因任何原因死亡和安全结果的影响.
主要成果:
- 密集的血压控制显示,在所有脆弱程度 (非脆弱,中度,严重) 上,对MACE和全因死亡有着一致的好处.
- 在虚弱状态和治疗对MACE或因任何原因死亡的影响之间没有观察到显著的相互作用.
- 在中度和重度虚弱的参与者中,严重的不良事件更为常见,但密集治疗对安全结果的影响与虚弱状态没有差异.
结论:
- 密集的缩血压准 (<120毫米升) 有利于高心血管风险的高血压患者,无论他们的脆弱程度如何.
- 密集治疗策略在整个脆弱的频谱中表现出一致的有效性和安全性.
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