Hypertension:开滦研究8万人新数据:收缩压持续>170 mmHg者脑出血风险增11倍,脑梗风险增4倍

2017-08-02 朱柳媛 中国循环杂志

近期,Hypertension杂志在线发表的开滦研究近8万人的最新数据表明,与收缩压正常(<120 mmHg)的人相比,收缩压持续在170 mmHg者人脑梗死风险增4倍,脑出血风险增加11.4倍。

近期,Hypertension杂志在线发表的开滦研究近8万人的最新数据表明,与收缩压正常(<120 mmHg)的人相比,收缩压持续在170 mmHg者人脑梗死风险增4倍,脑出血风险增加11.4倍。

1级高血压患者卒中风险也明显升高。

但如果收缩压一开始处于160 mmHg左右,4年后逐渐降低至140 mmHg左右的人,无论脑梗死,还是脑出血风险,都低于收缩压开始约为140 mmHg后来为160 mmHg左右的高血压患者。

研究者指出,应持续监测血压的变化,才能更清楚地了解卒中风险情况。

该研究显示,即便血压处于正常高值(120~139/80~89 mmHg)即前期高血压的人,脑梗死风险也增倍(HR=1.99),脑出血风险风险更高,增2倍(HR=3.11)。这与既往研究结果一致。

因此,研究者认为,采取更严格的血压控制策略或许能更有效地预防卒中,但目前仍没有证据确定卒中一级预防的最佳血压控制目标。

有Meta分析表明,收缩压<130 mmHg可显着降低卒中风险。但目前欧洲指南仍建议血压目标为140/90 mmHg,美国JNC8指南建议60岁以上人群以150/90 mmHg为降压目标。

该研究还提示,随访期间血压波动幅度较大的人卒中风险也明显升高。平均收缩压波动幅度≥15.3 mmHg的人,脑梗死风险比波动<4.99 mmHg的人增加72%,脑出血风险增加1.29倍。

与收缩压类似,舒张压、平均血压、平均动脉压和脉压的变化轨迹也与上述两种类型的卒中显着相关。

研究人员还发现,4年随访期间的血压变化轨迹与卒中风险之间的关系,在相对年轻(<60岁)或者没有糖尿病的人群中更明显。这说明,不同的人群需要采用不同的降压目标。

在该研究中,高血压前期人群占45%,血压正常者占33.7%,1级高血压升高或降低者分别占10.4%和8.1%,2级稳定高血压患者占2.9%。

原始出处:Li W, Jin C, Vaidya A, et al. Blood Pressure Trajectories and the Risk of Intracerebral Hemorrhage and Cerebral Infarction: A Prospective Study. Hypertension. 2017 Jul 17.

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    2017-08-04 karmond
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1726618, encodeId=00601e266186d, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu May 10 02:20:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1946780, encodeId=4c231946e80e8, content=<a href='/topic/show?id=a25e4966e43' target=_blank style='color:#2F92EE;'>#开滦研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49667, encryptionId=a25e4966e43, topicName=开滦研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b71f2500114, createdName=1179102698_36768926, createdTime=Mon Feb 19 12:20:00 CST 2018, time=2018-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038726, encodeId=f99c2038e2621, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Tue Dec 26 05:20:00 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1840311, encodeId=79dd184031144, content=<a href='/topic/show?id=10905e20546' target=_blank style='color:#2F92EE;'>#收缩压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57205, encryptionId=10905e20546, topicName=收缩压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Fri Jul 06 18:20:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465081, encodeId=11f21465081ae, content=<a href='/topic/show?id=2dea8489010' target=_blank style='color:#2F92EE;'>#脑梗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84890, encryptionId=2dea8489010, topicName=脑梗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccf56689148, createdName=karmond, createdTime=Fri Aug 04 02:20:00 CST 2017, time=2017-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501186, encodeId=4f871501186f7, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Fri Aug 04 02:20:00 CST 2017, time=2017-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229537, encodeId=b51022953e1f, content=谢谢分享,很不错。, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好!, createdTime=Thu Aug 03 11:48:43 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229211, encodeId=ac5822921192, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Aug 02 15:31:09 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229185, encodeId=8ed5229185d0, content=心脑血管联系紧密~, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C3426ED027FF661B0C576A5B3127C2E8/40, createdBy=39dc1706090, createdName=QQ25ed180f, createdTime=Wed Aug 02 14:01:03 CST 2017, time=2017-08-02, status=1, ipAttribution=)]
    2017-08-03 明天会更好!

    谢谢分享,很不错。

    0

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    2017-08-02 131****1460

    学习了受益匪浅。

    0

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    2017-08-02 QQ25ed180f

    心脑血管联系紧密~

    0

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