研究意义深远! JACC开滦研究新分析:<45岁高血压危险

2020-06-10 朱朱 文韬 中国循环杂志

在评估心血管风险时,目前指南并未建议考虑高血压发病年龄,也没有强调对年轻患者进行适当治疗的重要性。

在评估心血管风险时,目前指南并未建议考虑高血压发病年龄,也没有强调对年轻患者进行适当治疗的重要性。
 
而近日,解放军总医院薛浩和唐山开滦总医院吴寿岭教授等在JACC发表的开滦研究最新分析表明,高血压发病越早,心血管病和全因死亡风险越高。
 
同期述评指出,这项研究的意义深远。因为,“与老年才发生的高血压患者相比,有高血压的年轻人的终生心血管病风险明显较高。”
 
述评还建议,未来指南在更新时,应考虑修改年轻高血压患者的治疗策略。
 
在该研究中,多因素分析发现,随着高血压发病年龄增大,心血管病和死亡风险逐渐降低。
 
与无高血压者相比,不到45岁就确诊高血压的年轻人中,心血管病和全因死亡风险分别增加1.26倍和1.59倍。
 
在45~54岁期间确诊高血压的患者中,心血管病和全因死亡风险分别增加62%和112%。
 
在55~64岁期间确诊高血压的患者中,心血管病和全因死亡风险分别增加42%和30%。
 
在≥65岁出现高血压的患者中,心血管病和全因死亡风险分别增加33%和29%。
 
述评也指出,评估高血压发病年龄,可能有助于改善心血管病风险分层。另外,早发高血压可能需要更强的降压治疗策略,包括生活方式干预和降压药物治疗。
 
近期发表的一些研究提示,与老年时期出现的高血压相比,中年时期出现的高血压患者未来痴呆风险更高。
 
根据中国高血压调查研究,中国18~24岁、25~34和35~44岁人群中,高血压的患病率分别为4.0%、6.1%和15.1%。但越是在年轻人中,高血压控制率反而越低,上述三个人群的控制率仅仅0.6%、3.2%和9.9%,远远低于其他更大年龄组。
 
开滦研究为一项前瞻性队列研究,这项最新分析纳入其中首次调查期间(2006年7月至2007年10月)入选的71 245名无高血压和心血管病的成年人,所有人随访至2017年年末。
 
随访期间,20 221人确诊新发高血压,研究人员将年龄和性别与之相匹配的19 887名无高血压的成年人作为对照。
 
平均随访6.5年期间,发生1672例心血管事件,2008人死亡。
 
来源:
[1]Association of Age of Onset of Hypertension With Cardiovascular Diseases and Mortality. J Am Coll Cardiol, 2020, 75(23): 2921-2930.
[2]Early-Onset Hypertension: Under-Recognized, Under-Treated, and Under-Estimated in Risk. J Am Coll Cardiol, 2020, 75(23): 2931-2933.
[3]Wang Z; Chen Z; Zhang L, et al. Statusof Hypertension in China: Results from the China Hypertension Survey, 2012-2015. Circulation. 2018; 137(22): 2344-2356.

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    2021-05-06 zhmscau
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    2020-08-27 hbwxf
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    2020-09-09 12177770m58暂无昵称

    学习了

    0

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    2020-06-10 lovetcm

    #心血管#高血压发病越早,心血管病和全因死亡风险越高。同样肥胖也是如此,糖尿病也是一样,青少年的陪伴和青少年的糖尿病对日后的危害是更大的。

    0

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