J Am Heart Assoc:1级高血压控制达标,5年内中风风险降60%

2017-04-27 朱柳媛 中国循环杂志

对于1级高血压即收缩压140-159mmHg和(或)舒张压90-99 mmHg的患者,降压治疗是否能降低死亡或心血管事件风险,既往的Meta 分析得出了不一致的结论。 近期,南方医科大学南方医院侯凡凡院士等报告的中国卒中一级预防试验(CSPPT)结果表明,对于没有心血管病的1级高血压患者,血压降到140/90 mmHg以下可以显著降低首次中风和死亡风险。 研究人员发现,接受降压

对于1级高血压即收缩压140-159mmHg和(或)舒张压90-99 mmHg的患者,降压治疗是否能降低死亡或心血管事件风险,既往的Meta 分析得出了不一致的结论。

近期,南方医科大学南方医院侯凡凡院士等报告的中国卒中一级预防试验(CSPPT)结果表明,对于没有心血管病的1级高血压患者,血压降到140/90 mmHg以下可以显著降低首次中风和死亡风险。
 
研究人员发现,接受降压治疗4.6年左右,与治疗期间平均收缩压≥140 mmHg者相比,平均收缩压控制在120~140 mmHg之间的患者首次中风的风险降低61%(两类患者首次中风发生率分别为2.9%和1.1%)。
 
与治疗期间平均舒张压≥90 mmHg者相比,平均舒张压维持在90mmHg以下的患者首次中风的风险降低59%(两类患者首次中风发生率分别为2.7%和1.5%)。
 
不过,收缩压也不能过低,控制在120~140mmHg最好。治疗期间平均收缩压如果低于120 mmHg,首次中风风险是收缩压维持在120~140 mmHg者的3.43倍,这一风险甚至高于收缩压≥140 mmHg者(HR=2.58)。
 
研究还显示,治疗期间平均收缩压处于120~140mmHg之间时,复合心血管事件和全因死亡风险也是最低的。
 
研究人员认为,“由于人群中不合并心血管病的1级高血压患者比例很高,我们的这些结果有重要的启示意义。”
 
这项研究共纳入3187例1级高血压患者,按1:1比例分为两组,一组服用依那普利叶酸,另一组服用依那普利,总停药率为1.5%。52例患者首次出现中风。
 
原始出处:
Qin X, Li Y, Sun N, et al. Impact of Achieved Blood Pressure on First Stroke in Uncomplicated Grade 1 Hypertension. J Am Heart Assoc, 2017, 6:e005247.

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    2017-05-04 jyzxjiangqin

    高血压病的治疗。

    0

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    2017-04-29 zhaojie88
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1739686, encodeId=5bb31e3968691, content=<a href='/topic/show?id=ff0c2262459' target=_blank style='color:#2F92EE;'>#中风风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22624, encryptionId=ff0c2262459, topicName=中风风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Tue May 09 13:14:00 CST 2017, time=2017-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193552, encodeId=4a1e193552e5, content=高血压病的治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu May 04 07:20:58 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356243, encodeId=a6a713562433e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Apr 29 04:14:00 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446286, encodeId=289e14462866d, content=<a href='/topic/show?id=875e88946d1' target=_blank style='color:#2F92EE;'>#血压控制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88946, encryptionId=875e88946d1, topicName=血压控制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28a45200046, createdName=gj0733, createdTime=Sat Apr 29 04:14:00 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562500, encodeId=c6b81562500a1, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Apr 29 04:14:00 CST 2017, time=2017-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191151, encodeId=1172191151b6, content=Good, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJeleNbkWksiaqto3Vibw7iaYDyibpLMHK1vvGGiaRIsssgewmhUCCaqreYPhPjz9vyIozwdibIjYkfA87Q/0, createdBy=2b112040124, createdName=Anyway, createdTime=Thu Apr 27 17:10:58 CST 2017, time=2017-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191138, encodeId=e23019113840, content=不错学习很好有进步有提高, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220814/be36b1918b4c4eeba48ae6c167571ce9/3bd4e17f256d4fdba54abc66bb0f616c.jpg, createdBy=a4042044999, createdName=jiangwei200908, createdTime=Thu Apr 27 15:48:38 CST 2017, time=2017-04-27, status=1, ipAttribution=)]
    2017-04-29 slcumt
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    2017-04-27 Anyway

    Good

    0

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    2017-04-27 jiangwei200908

    不错学习很好有进步有提高

    0

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