Hypertension:长期血液透析患者血压与心血管事件风险!

2017-07-04 xing.T MedSci原创

总之,在血液透析患者中,尽管透析单元内SBP与心血管疾病风险存在U形(矛盾)关联,但透析单元外SBP与心血管疾病的风险存在线性关联。透析单位外血压提供了关键信息,并可能是一个重要的治疗靶标。

研究人员最近报道了较高的收缩压(SBP)与血液透析患者死亡风险之间存在线性关联,当SBP是在透析单元外进行测量(透析单元外SBP)时,尽管在透析单元内测量的SBP与死亡风险之间存在存在U形关联。近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员探讨了SBP与心血管事件之间的关系,这些事件具有重要的治疗意义,但尚未得到很好的阐明。

在招募入前瞻性CRIC研究(慢性肾功能不全的队列)中的383例血液透析患者中,研究人员采用多元样条曲线和Cox模型来研究SBP和裁决的心血管事件(心力衰竭、心肌梗死、缺血性卒中和外周动脉疾病)之间的相关性,对不同的人口学、心血管疾病的危险因素和透析参数进行控制。

透析单元SBP与透析单元外SBP呈中度相关(r=0.34,p<0.001)。研究人员发现透析单元SBP与心血管事件风险之间存在U形关联,在140至170mmHg之间风险最低。相反,透析单元外SBP与心血管事件之间存在线性逐步关联。透析单元外SBP≥128mmHg(前2个四分位数)的参与者相比于那些从透析单元外SBP≤112mmHg的参与者心血管事件的风险增加2倍(第3四分位数:调整后的风险比为2.08,95%可信区间[3.87-1.12]和第4四分位数:调整后的风险比为2.76,95%可信区间[1.42-5.33])。

总之,在血液透析患者中,尽管透析单元内SBP与心血管疾病风险存在U形(矛盾)关联,但透析单元外SBP与心血管疾病的风险存在线性关联。透析单位外血压提供了关键信息,并可能是一个重要的治疗靶标。

原始出处:

Nisha Bansal,et al. Blood Pressure and Risk of Cardiovascular Events in Patients on Chronic Hemodialysis The CRIC Study (Chronic Renal Insufficiency Cohort).Hypertension.2017. https://doi.org/10.1161/HYPERTENSIONAHA.117.09091

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    2017-12-21 feather89
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    2017-07-10 大爰

    学习了谢谢分享!!

    0

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    2017-07-06 habb
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    2017-07-04 139****5926

    好好文章学习了

    0

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