Hypertension:高血压患者房颤的发生率及其意义

2020-05-06 MedSci原创 MedSci原创

在年龄较大,高风险的非糖尿病人群中,强化降压不会降低新发AF的发生率。既往和新发AF对患者都有不良的预后影响。在既往AF的受试者中,即使治疗时血压<120/80mmHg,仍存在残留的心血管风险。

近日,高血压领域权威杂志Hypertension上发表了一篇研究文章,研究人员旨在通过收缩压干预试验(SPRINT)参与者评估强化降压对新发房颤/房扑(AF)发生率以及既往和新发AF患者预后的影响。

新发性AF定义为在基线时无房颤的受试者,在随机分组后在12导联心电图检查中出现的AF。研究人员泊松回归模型来计算新发AF的发生率,并使用多变量调整的Cox比例风险模型评估不良心血管事件(心肌梗死、非心肌梗死急性冠状动脉综合征、卒中、心力衰竭或心血管死亡的复合事件)的风险。

在9327名参与者中,有8.45%患者既往有AF,而1.65%的患者有新发AF。新发AF的发生率为每1000人每年4.53人次,在标准治疗和强化降压组中的发生率相近(每1000人每年4.95人次 vs. 4.11人次;校正后的P=0.14)。既往AF患者(风险比调整后为1.83 [95%CI为1.46-2.31];P<0.001)和新发AF患者(风险比调整后为2.45 [95%CI为1.58-3.80];P<0.001)与没有AF的人相比,发生心血管不良事件的风险更大。与没有AF的患者相比,既往有AF且在3个月内血压<120/80 mmHg的参与者预后较差(调整后的风险比为1.88[95%CI为1.32-2.70];P=0.001)。

由此可见,在年龄较大,高风险的非糖尿病人群中,强化降压不会降低新发AF的发生率。既往和新发AF对患者都有不良的预后影响。在既往AF的受试者中,即使治疗时血压<120/80mmHg,仍存在残留的心血管风险。

原始出处:

Vibhu Parcha,et al.Incidence and Implications of Atrial Fibrillation/Flutter in Hypertension Insights From the SPRINT Trial.Hypertension.2020.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.14690

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    2020-12-03 feather89
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    2020-05-06 心介

    房颤,临床上碰到很多哦

    0

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    2020-05-06 阿菡

    房颤在高血压病患者中非常常见,所以这篇文章写得很好,也学习了

    0

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