Circulation:伴无症状主动脉瓣狭窄的高血压患者其更佳血压控制目标应该是多少?

2016-08-08 MedSci MedSci原创

关于伴有无症状主动脉瓣狭窄(AS)的高血压患者治疗的研究甚少。本研究使用来自辛伐他汀和依泽替米贝治疗主动脉瓣狭窄(SEAS)试验的数据来评估该类患者最佳的血压控制目标。 研究共分析了1767例无症状性AS和无明显的动脉粥样硬化性疾病的患者。研究结果为全因死亡率、心血管死亡、心力衰竭、脑卒中、心肌梗死(MI)和主动脉瓣置换术(AVR)。使用Cox模型分析作为连续测量BP的累计平均值,及随时间变

关于伴有无症状主动脉瓣狭窄(AS)的高血压患者治疗的研究甚少。本研究使用来自辛伐他汀和依泽替米贝治疗主动脉瓣狭窄(SEAS)试验的数据来评估该类患者最佳的血压控制目标。

研究共分析了1767例无症状性AS和无明显的动脉粥样硬化性疾病的患者。研究结果为全因死亡率、心血管死亡、心力衰竭、脑卒中心肌梗死(MI)和主动脉瓣置换术(AVR)。使用Cox模型分析作为连续测量BP的累计平均值,及随时间变化的协变量。

结果,平均收缩压≥160毫米汞柱的患者其全因死亡率最高,而平均收缩压为120-139毫米汞柱的患者其全因死亡率最低。多变量分析中,以收缩压BP为120-139毫米汞柱,舒张压BP和脉压为70-79毫米汞柱和 60-69毫米汞柱为参考,全因死亡率与平均收缩压BP<120毫米汞柱,舒张压BP≥90毫米汞柱及脉压<50 mmHg有关。对于中等程度的AS患者来说,低收缩压和舒张压BP增加了其风险。使用时间变量收缩压从130到139毫米汞柱作为参考,收缩压BP≥160毫米汞柱和BP为120-129毫米汞柱的患者其死亡率明显增高。

总而言之,该研究发现,对于无症状AS及无明显粥样硬化性疾病或糖尿病的患者来说,最佳的BP似乎是收缩压为130-139毫米汞柱,舒张压为70-90毫米汞柱无症状。


原始出处:

Olav W. Nielsen, Ahmad Sajadie, et al., Assessing Optimal Blood Pressure in Patients with Asymptomatic Aortic Valve Stenosis: The SEAS Study. Circulation, August 2, 2016.

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    0

  4. 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  5. 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createdName=zll0631, createdTime=Wed Aug 10 13:49:00 CST 2016, time=2016-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97213, encodeId=be7a9e21337, content=厉害,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151110/IMG5641A6F12C0732294.jpg, createdBy=2f901662448, createdName=乐奕11, createdTime=Wed Aug 10 06:49:00 CST 2016, time=2016-08-10, status=1, ipAttribution=)]
  6. 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  7. 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  8. 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  9. 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  10. 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createdName=zll0631, createdTime=Wed Aug 10 13:49:00 CST 2016, time=2016-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=97213, encodeId=be7a9e21337, content=厉害,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151110/IMG5641A6F12C0732294.jpg, createdBy=2f901662448, createdName=乐奕11, createdTime=Wed Aug 10 06:49:00 CST 2016, time=2016-08-10, status=1, ipAttribution=)]
    2016-08-10 乐奕11

    厉害,学习了

    0