在分级运动中静脉血压反应的形状:方法,相关值和预测值
Nicholas Cauwenberghs1, Anna Carlén2,3, Thomas Lindow4
1Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Journal of human hypertension
|November 14, 2025
概括
运动期间晚期缩血压 (SBP) 升高独立预测男性全因死亡率增加,强调评估SBP反应形状的临床相关性. 这一发现表明,对于心血管健康来说,一种潜在的新风险分层工具.
科学领域:
- 心脏病学 心脏病学
- 运动生理学 运动生理学
- 生物统计学 生物统计学
背景情况:
- 系统性血压 (SBP) 通常在分级运动期间线性增加.
- 从这种线性反应中观察到偏差,但缺乏算法评估的标准化框架,限制了对其临床意义的理解.
- 以前的研究还没有系统地分析运动期间SBP反应的形状及其与死亡率的关联.
研究的目的:
- 通过算法识别在最大运动期间SBP响应的不同形状.
- 调查这些SBP反应形状与临床因素的关联.
- 确定SBP反应形状与全因死亡率之间的关系.
主要方法:
- 从5633名接受最大循环人体力测试的患者的SBP记录的回顾性分析.
- 调整SBP值 (0-100%) 以获得每个患者的SBP反应形状.
- 基于组的轨迹建模 (GBTM) 以性别分类SBP形状,然后进行后勤回归和Cox生存分析.
主要成果:
- 在两性中,GBTM确定了三种SBP反应形状:早期,线性和晚起.
- 晚期SBP升高与更高的休息SBP,更低的峰值SBP,更小的SBP升高,年龄更大,更高的BMI,β阻塞剂使用,以及更低的运动能力有关.
- 晚期SBP上升独立预测男性 (aHR=1.66) 的全因死亡率增加,但女性 (aHR=1.06) 的死亡率没有增加.
结论:
- 运动期间SBP反应的形状,特别是晚起,在生理和临床上都很重要.
- 晚期SBP上升与较差的风险概况有关,并独立预测男性全因死亡率.
- 在运动期间评估SBP反应形状可能为风险分层提供有价值的见解.
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