Hypertension:高血压前期进展为高血压的患者,左室肥厚风险更高

2019-03-09 国际循环编辑部 国际循环

近期,研究人员对PAMELA (Pressioni Monitorate E Loro Associazioni)处登记人群进行横断面和纵向数据分析,以评估左心室质量指数(LVMI)正常的亚组人群中入组时高血压前期和左心室肥厚(LVH)的关系以及相关的新发左室肥厚风险。最终研究结果发表于Hypertension杂志。基线状态下,横断面分析共纳入1397例超声心动图参数可测的未治疗患者。纵向分析则纳

近期,研究人员对PAMELA (Pressioni Monitorate E Loro Associazioni)处登记人群进行横断面和纵向数据分析,以评估左心室质量指数(LVMI)正常的亚组人群中入组时高血压前期和左心室肥厚(LVH)的关系以及相关的新发左室肥厚风险。最终研究结果发表于Hypertension杂志。

基线状态下,横断面分析共纳入1397例超声心动图参数可测的未治疗患者。纵向分析则纳入880例基线时无LVH且10年随访期后可测量LVMI的受试者者。入组时,在对主要混杂因素进行调整后,LVH患病率(LVM/体表面积)从正常血压人群(2.1%)、到高血压前期人群(6.7%)、再到高血压组(18.3%),逐渐显著增长。血压正常组、高血压前期组和高血压组受试者的LVH发生率分别为9.0%、23.2%、36.5%,LVH发生率逐渐升高。与持续性高血压前期的患者(OR=1.89;95%CI:0.77~5.11;P=0.21)相比,高血压前期进展为持续高血压的患者,其新发LVH风险显著增加(OR=4.21;95%CI:1.64~10.83;P=0.003)。随访时,在对受试者的年龄、性别及基线LVMI、肥胖、葡萄糖水平、肌酐水平、总胆固醇水平、降压药使用等因素进行调整后,将高血压前期组和高血压组的患者与持续血压正常的受试者加以比较。研究结果显示,在随访期间,进一步调整体重指数、代谢变量和肌酐变化情况后,高血压前期和新发LVH的关联强度并未受到影响。

研究人员认为,该研究结果为高血压前期与LVH存在相关性提供了新的证据,并认为应加强对受此影响的大部分普通人群的预防管理

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