Hypertension:80至90岁高血压人群的家庭血压临界值

2015-08-12 小田 译 医学论坛网

研究者们分析了375例80至90岁受试者(女性60.3%,平均年龄83.0岁),对其中位随访5.5年。结果显示,共有155例受试者死亡,其中76例源于心血管疾病,而经历心血管、心脏、冠状动脉或脑血管事件的数量分别为104、 55、36和51例。在202例未接受治疗的受试者中,与多变量校正平均危险相比,家庭舒张压在最低五分位(≤65.1 mm Hg)的

研究者们分析了375例80至90岁受试者(女性60.3%,平均年龄83.0岁),对其中位随访5.5年。

结果显示,共有155例受试者死亡,其中76例源于心血管疾病,而经历心血管、心脏、冠状动脉或脑血管事件的数量分别为104、 55、36和51例。

在202例未接受治疗的受试者中,与多变量校正平均危险相比,家庭舒张压在最低五分位(≤65.1 mm Hg)的患者与心血管死亡和发病率风险增加有关[危险比(HR)≥1.96; P≤0.022],而最高五分位(≥82.0 mm Hg)患者的心血管死亡危险比为0.37 (P=0.034)。

在173例接受高血压治疗的患者中,家庭收缩压在最低五分位(<126.9 mm Hg)的患者总死亡危险比为2.09 (P=0.020)。

对家庭血压持续变量进一步分析显示,在未接受治疗的受试者中,舒张压较高预示着较低的心血管死亡率和发病率以及心脏和冠脉风险(HR≤0.65; P≤0.039)。而在接受治疗的患者中,心血管发病率与家庭收缩压呈曲线相关性,最低点在148.6 mm Hg处,在这个临界值以下,每降低1SD的HR值为1.45(P=0.046)。


原始出处

Lucas S. Aparicio, et al. Defining Thresholds for Home Blood Pressure Monitoring in Octogenarians.HYPERTENSIONAHA.July 27, 2015

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