Hypertension:门诊治疗高血压患者左室肥厚风险知多少?

2016-12-03 xing.T MedSci原创

尽管更积极的降压治疗,21%的高血压患者出现明确的左心室肥厚。调整混杂因素后,发生左心室肥厚的风险与女性尤为相关,当存在肥胖的情况时其风险将进一步增加。

在接受降压治疗的高血压患者中报道左心室肥厚发生发展的研究较少,近日,心血管权威杂志Hypertension上发表一篇来自意大利费德里克二世大学高血压病研究中心的Raffaele Izzo医生及其团队的研究文章,研究人员评估了在接受降压治疗的高血压患者中左心室肥厚发生率,这些研究对象来自坎帕尼亚致敬网络登记处。 

研究人员前瞻性地分析了4290例至少随访一年的高血压患者(50.3±11.1岁,40%为女性),在研究之初无左心室肥厚。左心室肥厚发生是指通过超声心动图第一次检测到左室质量指数47g/m2.7(女性)或50g/m2.7(男性)。中位随访时间为48个月,研究人员发现其中915例患者(21.3%)发生左心室肥厚。这群患者的主要特征为:年龄较大,更多的为女性,肥胖(P0.0001),较高的基础空腹血糖、舒张压、收缩压、左心室重量指数,降低的心率和肾小球滤过率,较长的高血压病史和随访时间和随访期间更高的平均收缩压(所有P均<0.05),而且采用钙通道阻滞剂和利尿剂治疗很常见(P均<0.02)。 

在多变量Cox回归分析中,研究人员发现左心室肥厚的发生与更大年龄、女性、肥胖、在随访过程中更高的平均收缩压和较大的左室基础质量指数存在独立相关性(P均<0.02)。根据肥胖和性别将患者进行分类,在男性和女性中,肥胖与左心室肥厚发生风险增加独立相关(男性中肥胖者比上非肥胖者风险比为1.34;可信区间为1.05-1.72P=0.019;女性在肥胖者比上非肥胖者的风险比为1.34;可信区间为1.08-1.66P=0.007)。 

尽管更积极的降压治疗,21%的高血压患者出现明确的左心室肥厚。调整混杂因素后,发生左心室肥厚的风险与女性尤为相关,当存在肥胖的情况时其风险将进一步增加。 

原始出处: 

Raffaele Izzo, et al. Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients The Campania Salute Network. Hypertension. November 28, 2016. 

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    2017-10-03 feather89
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    2016-12-05 susice

    除血压外,其他SCVD的危险因素也应控制

    0

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    2016-12-03 知难而进

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