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在2型糖尿病中假设的降血压干预下心血管结果:一个向试验仿真试验
Xue Tian1,2,3,4, Shouling Wu5, Xue Xia1,2,3,4
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Diabetes, obesity & metabolism
|January 20, 2026
概括
在2型糖尿病患者中,降低缩血压 (SBP) 到120mmHg以下可能会增加死亡风险. 虽然较低的SBP目标降低了心血管疾病 (CVD) 风险,但SBP ≤120 mmHg对于这一群体的整体死亡率不是最佳的.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 对于患有2型糖尿病 (T2DM) 的患者来说,缩血压 (SBP) 控制目标仍然不一致.
- 强化SBP降低对心血管疾病 (CVD) 和T2DM死亡率的风险-益处概况尚未完全阐明.
研究的目的:
- 评估维持SBP低于特定临床值 (140,130,120 mmHg) 对T2DM患者心血管疾病风险和全因死亡率的模拟效应.
- 确定最佳的SBP目标,以平衡糖尿病患者的心血管疾病风险降低和全因死亡率.
主要方法:
- 分析了Kailaun研究中的4264名T2DM患者队列.
- 用参数g公式来模拟假设的干预措施,以减少随着时间的推移SBP.
- 考虑了时间变化的混,并报告了10年CVD和全因死亡风险的风险比率 (RR) 和需要治疗的数量 (NNT).
主要成果:
- 保持SBP低于140,130和120mmHg与18%,24%和31%的心血管疾病相对风险降低有关.
- 对于140或130mmHg的SBP目标,没有观察到对所有原因死亡率的显著益处.
- 维持SBP≤120 mmHg显著增加了15%的全因死亡率,并显示了老年患者或不服用抗高血压药物的患者的潜在危害.
结论:
- 对于患有2型糖尿病的中国患者来说,由于CVD和全因死亡率的不良风险-益处关联,维持SBP≤120 mmHg可能不是最佳目标.
- 这些发现表明需要在糖尿病患者中个性化SBP目标,考虑到过度强烈降低血压的潜在风险.
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