Diabetes Care:血压变异性与心力衰竭风险

2020-04-24 MedSci原创 MedSci原创

血压变异性与2型糖尿病患者的HF风险有关,这可能是舒张期缺血的结果。这些结果可能对优化2型糖尿病患者的血压治疗策略具有重要意义。

尽管越来越多的研究表明血压变异性作为心血管疾病的危险因素,但其与心力衰竭(HF)的关系尚不清楚。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员通过参加血糖和/或其他危险因素管理试验的两个2型糖尿病队列旨在评估血压变异性与HF风险之间的关系。

该研究的数据来自糖尿病控制心血管风险行动(ACCORD)试验和退伍军人事务糖尿病试验(VADT)。在两个试验中,研究人员均计算了收缩压(SBP)和舒张压(DBP)的变异系数(CV)和平均实际变异性(ARV),以及最大和累积平均SBP和DBP。

在ACCORD中,即使在调整了其他危险因素和平均血压之后,SBP和DBP的CV和ARV也与HF风险增加相关(例如,CV-SBP:风险比[HR]为1.15,P=0.01; CV- DBP:HR为1.18,P=0.003)。在VADT中,DBP变异性与HF风险增加相关(ARV-DBP:HR为1.16,P=0.001; CV-DBP:HR为1.09,P=0.04)。此外,在ACCORD中,基线血压逐渐降低的个体HF风险随CV-SBP、ARV-SBP和CV-DBP升高而逐步增加。血压变异性的效应与血压的下降有关,而跟血压升高无关。

由此可见,血压变异性与2型糖尿病患者的HF风险有关,这可能是舒张期缺血的结果。这些结果可能对优化2型糖尿病患者的血压治疗策略具有重要意义。

原始出处:

Daniel S. Nuyujukian,et al.Blood Pressure Variability and Risk of Heart Failure in ACCORD and the VADT.Diabetes Care.2020.https://care.diabetesjournals.org/content/early/2020/04/22/dc19-2540

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    2020-05-09 thm112988

    0

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    2020-04-24 心介

    #血压变异性#相信未来5年是热点,不仅关心血压高与低,还要关注血压变异性才可以

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