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在患有左心室缩症的患者中缩血压的目标

Sverre E Kjeldsen¹, Brent Egan², Giuseppe Mancia³

¹Department of Cardiology, Oslo University Hospital, Ullevaal, and Institute for Clinical Medicine, University of Oslo, Building No. 3, Kirkeveien 166, Oslo N-0407, Norway.

European journal of internal medicine

|February 12, 2026

概括

在患有左心室缩 (LVH) 的老年高血压患者中,降低静脉血压到130 mmHg以下可能会增加死亡率. 在为这些人设定血压目标时,建议谨慎.

科学领域:

心脏病学心脏病学
高血压研究高血压研究
临床试验临床试验

背景情况:

左心室缩 (LVH) 是高血压的常见心脏并发症,影响高达50%的患者.
现有的高血压指南为LVH患者管理血压目标提供了有限的具体指导.
之前的结果试验表明,在中年和老年高血压人群中,强度降低血压 (静脉压<130 mmHg) 存在潜在的安全问题.

研究的目的:

在患有 LVH 的高血压患者中,审查与低缩血压目标相关的潜在风险.
分析主要临床试验的数据,以分析心电图定义的高血压患者和不同血压目标的高血压患者的死亡结果.

主要方法:

来自洛萨坦干预终点减少 (LIFE) 研究的数据分析 (n=9,193) 专注于ECG-LVH.
检查瓦尔萨坦抗高血压药长期使用评估 (VALUE) 试验 (n=2,458) 的数据,该试验对ECG-LVH患者进行了检查.
时间变化分析,以评估达到特定的缩血压水平对死亡率的影响.

主要成果:

在LIFE试验中,达到静缩血压≤130 mmHg与静缩血压≥142 mmHg相比,全因死亡率增加了37% (p=0.005).
在ECG-LVH患者中,VALUE试验显示了较高的全因和心脏死亡率,这些患者的平均静脉压<130 mmHg.
这两项试验都表明,当心压血压降低到130 mmHg以下时,患有ECG-LVH的50岁及以上患者的死亡风险增加.

结论:

在中年和老年高血压患者中,降低静脉压<130 mmHg,患有ECG-LVH,可能与死亡率增加有关.
需要进行进一步的研究,以确定 LVH 的高血压患者的最佳静脉血压目标.
在这个患者队列中考虑静脉压目标低于130mmHg时,建议谨慎.

关键词:

血压血压血压血压心血管疾病的心血管疾病电心电图是指心电图.准则准则准则准则在高血压的高血压.左心室过度缩小的情况目标血压为目标血压.

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