JACC:高血压患者可通过早晨家庭血压(HBP)预测心血管事件的发生

2016-03-29 MedSci MedSci原创

很少有研究评估办公室外的血压(BP)作为冠状动脉疾病(CAD)事件的预测因子。本研究的目的是要确定早晨家庭血压(HBP)作为心血管事件的预测因子。研究人员使用来自HONEST(未建立标准目标血压患者的家庭血压测量)研究的数据,检测了早晨HBP和卒中以及CAD事件发生率之间的关系。在21591例接受治疗的高血压患者中(平均年龄64.9岁;平均随访2.02年),共发生127例脑卒中事件(每1000病人

很少有研究评估办公室外的血压(BP)作为冠状动脉疾病(CAD)事件的预测因子。

本研究的目的是要确定早晨家庭血压(HBP)作为心血管事件的预测因子。

研究人员使用来自HONEST(未建立标准目标血压患者的家庭血压测量)研究的数据,检测了早晨HBP和卒中以及CAD事件发生率之间的关系。

在21591例接受治疗的高血压患者中(平均年龄64.9岁;平均随访2.02年),共发生127例脑卒中事件(每1000病人年2.92例)和121例CAD事件(每1000病人年2.78例)。早晨家庭收缩压(HSBP)≥145mm Hg的患者与<125mm Hg的患者相比,卒中事件的发生率显著更高,临床收缩压(CSBP)≥150mm Hg的患者卒中事件发生率显著高于<130mm Hg的患者。早晨HSBP≥155mm Hg和早晨HSBP<125mm Hg的患者相比的危险比(HR)为6.01(95%可信区间(CI):2.85至12.68),CSBP≥160mm Hg和那些与CSBP<130mm Hg的患者相比危险比为5.82(95%CI 3.17至10.67);早晨HSBP预测卒中事件与CSBP类似。早晨HSBP≥145mm Hg的患者CAD事件的发生率显著高于<125mm Hg的患者,CSBP≥160mm Hg的患者显著高于<130mm Hg的患者。早晨HSBP≥155mm Hg的HR为6.24(95%CI:2.82至13.84),CSBP≥160mm Hg为3.51(95%CI:1.71 7.20);因此,与早晨HSBP相比,CSBP可能低估了CAD风险。拟合优度分析表明,上午HSBP预测CAD事件比CSBP更强烈。

早晨HBP是未来的CAD,脑卒中事件的一个强有力的预测,并且在这方面可能优于临床BP。在早晨HBP和卒中或CAD事件之间可能会出现J曲线的关系。

原始出处:

Kazuomi Kario,Ikuo Saito,Toshio Kushiro,et al.Morning Home Blood Pressure Is a Strong Predictor of Coronary Artery Disease,JACC,2016.3.29

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    2017-01-08 hbwxf
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    2016-04-19 MedSci客户端网友

    200000

    0

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    2016-03-30 lovetcm

    这个研究表明,早晨的血压监测,非常关键。

    0

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