JAHA:高血压患者诊室血压与心血管事件

2021-03-20 MedSci原创 MedSci原创

在所有高血压患者中,BP水平均与MACE风险显著相关。但是,在接受降压治疗的BP<120/70 mmHg的患者中,并无额外的MACE益处。

高血压患者诊室血压(BP)的最佳治疗目标范围尚未明确。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员使用韩国国民健康保险服务数据库,提取了479359名高血压患者的数据,这些患者2002年至2011年期间的BP值可用,且无心血管疾病。

该研究终点为主要心血管事件(MACE),由心血管死亡、心肌梗塞或卒中组成。这项队列研究评估了BP水平(<120/<70、120-129/70-79、130-139/80-89、140-149/90-99和≥150/≥100mmHg)之间的关联。

在9年的中位随访期间,该研究队列记录了55401个MACE事件。BP在<120/<70 mmHg的水平下,发生MACE的风险最低(风险调整比[HR]为0.79;95%CI为0.76-0.84),BP在≥150/≥100mmHg的水平下,风险最高(HR为1.32;95%CI为为1.29-1.36),相比于BP为130至139/80至89 mmHg的水平。这些结果在所有年龄段和男女患者中均一致。在接受降压药物治疗的患者中(n=237592,49.5%),与BP为130至139/80至89 mmHg水平相比,血压升高(≥140/≥90mmHg)的患者发生MACE的风险明显更高,但对于BP<130/<80 mmHg的患者,并没有显著降低。在所有年龄段,BP<120/70 mmHg与全因或心血管死亡的风险增加相关。

在所有高血压患者中,BP水平均与MACE风险显著相关。但是,在接受降压治疗的BP<120/70 mmHg的患者中,并无额外的MACE益处

原始出处:

Chang Hee Kwon .et al.Office Blood Pressure Range and Cardiovascular Events in Patients With Hypertension: A Nationwide Cohort Study in South Korea.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.017890

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    2021-03-22 zhaohui6731
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1643735, encodeId=5a581643e35b2, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Fri Sep 10 11:46:36 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976569, encodeId=121019e65696b, content=<a href='/topic/show?id=177f9156168' target=_blank style='color:#2F92EE;'>#诊室血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91561, encryptionId=177f9156168, topicName=诊室血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Dec 06 04:46:36 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268466, encodeId=7a2912684662b, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1448330, encodeId=90f21448330b5, content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950042, encodeId=1b3e9500426c, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201117/a59b28b63198490ea85b1e5b3d13c2bf/1b1e0d03ca22467d8120443ebbc24c04.jpg, createdBy=35d22207591, createdName=zhangxiang, createdTime=Mon Mar 22 09:04:25 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949875, encodeId=818b9498e52f, content=应该同时统计患者的自测血压,看其之间有无关联。, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Sun Mar 21 12:18:43 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949770, encodeId=6c4a949e70e2, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Mar 20 20:25:06 CST 2021, time=2021-03-20, status=1, ipAttribution=)]
    2021-03-22 zhangxiang

    了解了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1643735, encodeId=5a581643e35b2, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Fri Sep 10 11:46:36 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976569, encodeId=121019e65696b, content=<a href='/topic/show?id=177f9156168' target=_blank style='color:#2F92EE;'>#诊室血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91561, encryptionId=177f9156168, topicName=诊室血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Dec 06 04:46:36 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268466, encodeId=7a2912684662b, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1448330, encodeId=90f21448330b5, content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950042, encodeId=1b3e9500426c, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201117/a59b28b63198490ea85b1e5b3d13c2bf/1b1e0d03ca22467d8120443ebbc24c04.jpg, createdBy=35d22207591, createdName=zhangxiang, createdTime=Mon Mar 22 09:04:25 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949875, encodeId=818b9498e52f, content=应该同时统计患者的自测血压,看其之间有无关联。, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Sun Mar 21 12:18:43 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949770, encodeId=6c4a949e70e2, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Mar 20 20:25:06 CST 2021, time=2021-03-20, status=1, ipAttribution=)]
    2021-03-21 weigq

    应该同时统计患者的自测血压,看其之间有无关联。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1643735, encodeId=5a581643e35b2, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Fri Sep 10 11:46:36 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976569, encodeId=121019e65696b, content=<a href='/topic/show?id=177f9156168' target=_blank style='color:#2F92EE;'>#诊室血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91561, encryptionId=177f9156168, topicName=诊室血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Dec 06 04:46:36 CST 2021, time=2021-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268466, encodeId=7a2912684662b, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1448330, encodeId=90f21448330b5, content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Mon Mar 22 09:46:36 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950042, encodeId=1b3e9500426c, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201117/a59b28b63198490ea85b1e5b3d13c2bf/1b1e0d03ca22467d8120443ebbc24c04.jpg, createdBy=35d22207591, createdName=zhangxiang, createdTime=Mon Mar 22 09:04:25 CST 2021, time=2021-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949875, encodeId=818b9498e52f, content=应该同时统计患者的自测血压,看其之间有无关联。, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/9c448fe1b3b54fd7bc9477662f4861bb/4bdadad22bfd46f2921aabb4c40265d3.jpg, createdBy=a8d81938466, createdName=weigq, createdTime=Sun Mar 21 12:18:43 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949770, encodeId=6c4a949e70e2, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sat Mar 20 20:25:06 CST 2021, time=2021-03-20, status=1, ipAttribution=)]
    2021-03-20 wxl882001

    了解

    0

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