EUR HEART J-CARD PHA:不同年龄组的强化降压:从收缩压干预试验中得到的启示

2021-01-04 MedSci原创 MedSci原创

《2018年ESC/ESH高血压指南》建议对年龄小于65岁、65 - 79岁和≥80岁的患者进行差异管理。然而,目前还不清楚强化降压是否在不同年龄的人群中都能被患者很好地接受并改变风险。

高血压治疗是全程全面的健康管理的关键和重要环节。已患有高血压的病人需要早发现、·早诊断、早治疗和早期保护,合理用药平稳降压达标是防止高血压导致心血管并发症和靶器官损害的核心关键。《2018年ESC/ESH高血压指南》建议对年龄小于65岁、65 - 79岁和≥80岁的患者进行差异管理。然而,目前还不清楚强化降压是否在不同年龄的人群中都能被患者很好地接受并改变其风险等级。

近日,丹麦哥本哈根大学医院Rigshospitalet心脏中心心脏病科Christina Byrne等人在线发表了题为“Intensive blood pressure lowering in different age categories: insights from the Systolic Blood Pressure Intervention Trial”的研究。该研究团队对不同年龄阶段血压管理的结局开展了比较研究,发现年龄和降压结局和相关风险的相关性不显著

SPRINT随机抽取9361名无糖尿病、年龄≥50岁、收缩压130-180 mmHg的高危成人进行强化或标准降压治疗。主要疗效终点为急性冠状动脉综合征、中风、心力衰竭或由血管原因引起的死亡。主要安全终点为复合严重不良事件。使用Cox比例风险回归和限制三次样条来评估年龄是否改变强化降压和标准降压的有效性和安全性。年龄<65岁、65 - 79岁、≥80岁的分别有3805人(41%)、4390人(47%)、1166人(12%)。两组研究对象的平均年龄相似(强化组67.9±9.4岁vs标准组67.9±9.5岁;P = 0.94)。平均随访时间为3.3年。在多变量模型中,年龄与卒中风险线性相关(P < 0.001),与主要疗效事件、心血管原因死亡、任何原因死亡、心力衰竭和严重不良事件的风险非线性相关(P < 0.001)。无论是连续检测还是分类检测,强化降压的安全性和有效性均不受年龄的影响(p>0.05)

研究结果表明,在SPRINT研究中,根据ESC/ESH高血压指南提出的年龄分类在强化降血压的益处和风险方面没有显著差异

原始出处:

Christina Byrne,  Manan Pareek,Intensive blood pressure lowering in different age categories: insights from the Systolic Blood Pressure Intervention Trial

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    2021-01-06 liyu7822

    关键是长期控制

    0

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    2021-01-06 zhaojie88
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1840357, encodeId=13f4184035e10, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Tue Sep 28 10:01:40 CST 2021, time=2021-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=914066, encodeId=c9ea914066b6, content=关键是长期控制, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Wed Jan 06 13:07:28 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292094, encodeId=8170129209434, content=<a href='/topic/show?id=9d32981418b' target=_blank style='color:#2F92EE;'>#降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98141, encryptionId=9d32981418b, topicName=降压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f14236, createdName=经常头晕, createdTime=Wed Jan 06 01:01:40 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357634, encodeId=75c1135e634e2, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Jan 06 01:01:40 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419106, encodeId=adc4141910672, content=<a href='/topic/show?id=e051501461d' target=_blank style='color:#2F92EE;'>#强化降压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50146, encryptionId=e051501461d, topicName=强化降压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c6c3470765, createdName=fengxx, createdTime=Wed Jan 06 01:01:40 CST 2021, time=2021-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1563396, encodeId=908d1563396c6, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Wed Jan 06 01:01:40 CST 2021, time=2021-01-06, status=1, ipAttribution=)]