Hypertension:舒张压变化、冠状动脉钙化与心脏结局的相关性

2017-09-23 伊文 国际循环

既往研究显示,舒张压与冠心病及死亡呈J型曲线关系。这种相关性被认为是对舒张压较低时冠状动脉灌注减少的反映。AHA/ASH 2017科学会议上的一项研究旨在评估J型曲线关系是否在伴有冠状动脉钙化的人群中更显着。

既往研究显示,舒张压与冠心病及死亡呈J型曲线关系。这种相关性被认为是对舒张压较低时冠状动脉灌注减少的反映。AHA/ASH 2017科学会议上的一项研究旨在评估J型曲线关系是否在伴有冠状动脉钙化的人群中更显着。

研究对多种族动脉粥样硬化研究中6811例受试者进行了分析,采用Cox模型评估了舒张压分级是否与冠心病事件、卒中及死亡率具有相关性。多因素校正分析显示,与舒张压处于80~89 mm Hg者相比,舒张压<60 mm Hg者冠心病事件及全因死亡率风险增加,HR分别为1.69(95%CI:1.02~2.79)和1.48(95%CI:1.10~2.00);但卒中风险无差异。根据冠状动脉钙化进行分层分析可见,舒张压<60 mm Hg与上述事件的相关性仅在冠状动脉钙化评分>0的受试者中存在;在冠状动脉钙化评分为0的受试者中,舒张压< 60 mm Hg与上述事件并无相关性。此外,研究发现,舒张压较低与事件之间的相关性不受种族因素的影响。

总体来说,研究发现,舒张压<60 mm Hg可增加冠心病事件及全因死亡率风险。但是,上述作用似乎在伴有冠状动脉钙化的人群中更显着。这提示,对于伴有亚临床动脉粥样硬化者我们应审慎进行强化降压。


原始出处:
John W McEvoy, Faisal Rahman, Mahmoud Al Rifai. et al. Abstract 031: Diastolic Blood Pressure, Coronary Artery Calcium, and Cardiac Outcomes in the Multi-ethnic Study of Atherosclerosis. Hypertension. Sep 2017;70:A031

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createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Mon Sep 25 05:04:00 CST 2017, time=2017-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=247406, encodeId=b87924e4063f, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Mon Sep 25 00:54:08 CST 2017, time=2017-09-25, status=1, ipAttribution=)]
    2017-09-27 虈亣靌

    谢谢分享.学习了

    0

  7. 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    2017-09-25 飛歌

    学习了很有用不错

    0

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