Eur Heart J:睡眠血压:血管风险的预后标志和预防治疗靶点

2018-08-12 xing.T MedSci原创

由此可见,睡眠SBP是CVD事件中最重要的BP衍生危险因素。此外,治疗诱导的睡眠SBP降低,而不是清醒SBP,是高血压治疗的新目标,需要通过动态监测定期进行患者评估,并与CVD发病率和死亡率的风险显著降低有关。

睡眠时血压(BP)相比于清醒和24小时血压平均值是血管疾病(CVD)事件的一个更强的危险因素,但睡眠时血压作为降低血管疾病风险治疗靶点的潜在作用尚不确定。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在探究CVD风险降低是否与诊室或动态清醒或睡眠BP均值的逐渐减少最相关。

研究人员前瞻性地评估了18078名具有基线动态血压值的正常血压到高血压个体。受试者在纳入时和随访期间(每年一次),连续48小时测量动态血压。

在5.1年中位随访期间,有2311人发生了心血管事件,其中1209例发生了主要结局(CVD死亡、心肌梗死、冠状动脉血运重建、心力衰竭和卒中的复合事件)。睡眠时收缩压(SBP)平均值是主要结局最显著的BP衍生危险因素[风险比为1.29(95%CI)1.22-1.35/SD升高,P<0.001],无论诊室[1.03(0.97-1.09),P=0.32]还是清醒SBP [1.02(0.94-1.10),P=0.68]。最重要的是,在随访期间,睡眠SBP的逐渐降低是无事件生存的最重要标志[每降低SD为0.75(95%CI 0.69-0.82),P<0.001],无论诊室血压 [1.07(0.97-1.17)P=0.18]或清醒SBP平均值[0.96(0.85-1.08),P=0.47] 如何变化。

由此可见,睡眠SBP是CVD事件中最重要的BP衍生危险因素。此外,治疗诱导的睡眠SBP降低,而不是清醒SBP,是高血压治疗的新目标,需要通过动态监测定期进行患者评估,并与CVD发病率和死亡率的风险显著降低有关。

原始出处:


Ramón C Hermida.et al. Asleep blood pressure: significant prognostic marker of vascular risk and therapeutic target for prevention. Eur Heart J.2018. https://doi.org/10.1093/eurheartj/ehy475

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    2018-09-10 zwjnj2

    好好学习认真的学习

    0

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    2018-08-14 zhaojie88
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    2018-08-14 slcumt