预测发生心血管疾病的血压指数:在日本人口中进行了为期13年的随访研究
Takahiro Ichikawa1, Hiroshi Okada1,2, Hanako Nakajima1
1Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
American journal of preventive cardiology
|December 31, 2025
概括
平均动脉压 (MAP) 最好预测日本成年人心血管疾病 (CVD) 风险. 然而,其预测能力在女性和老年人中降低,突出显示了个性化风险评估的必要性.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 关于亚洲人群中各种血压指数的长期预后价值的证据有限.
- 心血管疾病 (CVD) 风险与多个血压指数相关,需要进行比较分析.
研究的目的:
- 为了研究多个BP指数与心血管疾病风险在13年内在一个大规模的日本人群中之间的关联.
- 为了比较系统血压 (SBP),透析血压 (DBP),脉冲压 (PP) 和发生心血管疾病的平均动脉压 (MAP) 的预后值.
主要方法:
- 对163,956名不服用抗高血压药物的日本参与者 (2008-2021) 的健康检查数据的分析.
- 主要结局:三点主要不良心脏事件 (MACE),包括心血管死亡,非致命冠状动脉疾病和非致命中风.
- 考克斯的比例危险模型和时间依赖的ROC分析被用于评估BP指数和MACE关联.
主要成果:
- 所有四个BP指数 (SBP,DBP,PP,MAP) 在混杂因子调整后都与事件MACE独立相关.
- 平均动脉压 (MAP) 显示了MACE (ROC曲线下的最高面积) 的最高预测能力.
- 在女性和年龄≥50岁的个体中,MAP的预测优势减弱.
结论:
- 平均动脉压 (MAP) 成为日本受研究人口中发生心血管疾病的最强预测因素.
- 这些发现强调了BP表型对心血管风险分层的重要性.
- 性别和年龄可能会改变MAP在预测心血管风险方面的实用性,建议采用个性化的方法.
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