Hypertension:万人国际研究:支持美国高血压指南中动态血压诊断标准

2019-08-11 朱柳媛 中国循环杂志

8月5日,Hypertension杂志发表的IDACO国际研究结果表明,根据中风、冠脉事件、心血管事件、死亡等临床事件的10年绝对发生风险,评估得出的动态血压阈值(结局驱动的动态血压阈值)与美国高血压新指南给出的动态血压阈值基本一致。

8月5日,Hypertension杂志发表的IDACO国际研究结果表明,根据中风、冠脉事件、心血管事件、死亡等临床事件的10年绝对发生风险,评估得出的动态血压阈值(结局驱动的动态血压阈值)与美国高血压新指南给出的动态血压阈值基本一致。

根据2017年美国心脏病学会(ACC)/美国心脏协会(AHA)发布的最新高血压指南,对应1级高血压的24小时、日间和夜间动态血压阈值依次为125/75、130/80、110/65 mmHg。

而该研究得出的数据显示,对应于诊室1级高血压,上述3个动态血压指标阈值分别为123.3/75.2、128.5/79.6、111.7/66.2 mmHg。

对应于正常高值血压,上述3个动态血压阈值依次为117.9/75.2、121.4/79.6、105.3/66.2 mmHg。

对应于诊室2级高血压,上述3个动态血压指标阈值分别为128.7/80.7、135.6/87.1、118.1/72.5 mmHg。

上述动态血压阈值经数值修约规则(rounding)后,与美国高血压新指南中的动态血压阈值基本一致。

仅在与重度高血压对应的动态血压阈值上,IDACO研究得出的结果与美国高血压新指南略有出入。



研究者指出,该研究结果支持采用美国高血压新指南中的动态血压阈值。

但需要注意的是,心血管并发症和血压之间的关系是连续性的。动态血压阈值有助于临床医生诊断和治疗高血压,但除考虑血压外,还需要考虑患者的整体临床情况,包括其他危险因素和合并症。

该研究共纳入来自欧洲、南美洲、亚洲13个人群,共11 152人,其中亚洲人占19.4%。其平均年龄为53岁,61.6%根据诊室血压水平存在高血压,19.6%应用降压药物。上海交通大学医学院附属瑞金医院王继光教授等参与这一研究。

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    2019-08-12 深海的鱼

    学习学习学习

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