Hypertension:一般高血压成年患者卒中预防收缩压控制在多少合适?

2017-02-28 xing.T MedSci原创

总之,在成年的无卒中、心肌梗死、糖尿病或肾功能下降病史的高血压患者中,较低的SBP目标值120-130mmHg,相比于SBP<120mmHg或130-140mmHg的目标值,可以使发生第一次卒中的风险最低。

近日,心血管权威杂志Hypertension上发表一篇来自中国学者的研究文章,研究人员评估了在CSPPT研究(中国脑卒中一级预防试验)中平均治疗的收缩压(SBP)与发生第一次卒中风险之间的相关性。

该研究是采用来自于随机对照双盲试验的CSPPT研究中的17720例成年没有心血管疾病、糖尿病和肾功能下降的高血压患者的数据进行事后分析。该研究的主要研究终点为首次卒中。在平均4.5年的随访期间,治疗平均SBP和首次卒中的风险之间的相关性遵循U型曲线,高于和低于120-130mmHg参考值范围发生卒中的风险增加。相比于治疗平均SBP在120-130mmHg(平均为126.2mmHg)范围的参与者,第一次卒中的风险不仅在SBP为130-135mmHg(平均为132.6mmHg;1.5% vs. 0.8%;风险比为1.63;95%可信区间为1.01-2.63)或135-140mmHg(平均为137.5mmHg;1.9% vs. 0.8%;风险比为1.85;95%可信区间为1.17-2.93)的参与者中是增加的,但在SBP<120mmHg(平均为116.7mmHg;3.1% vs. 0.8%;风险比为4.37;95%可信区间为2.10-9.07)的参与者中也是增加的。对年龄、性别和治疗组进行分层后的各亚组中也发现了相似的结果。此外,较低的舒张压与较低的卒中风险相关,在治疗舒张压<80mmHg时达到一个平台期。

总之,在成年的无卒中、心肌梗死糖尿病或肾功能下降病史的高血压患者中,较低的SBP目标值120-130mmHg,相比于SBP<120mmHg或130-140mmHg的目标值,可以使发生第一次卒中的风险最低。

原始出处:

Fangfang Fan, et al. Optimal Systolic Blood Pressure Levels for Primary Prevention of Stroke in General Hypertensive Adults.Findings From the CSPPT (China Stroke Primary Prevention Trial). Hypertension. 2017.https://doi.org/10.1161/HYPERTENSIONAHA.116.08499

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    2017-06-04 feather89
  4. 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createdName=12498ebem19暂无昵称, createdTime=Tue Sep 19 04:03:00 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726302, encodeId=d3201e2630219, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, 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=Sun Jun 04 17:03:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190352, encodeId=df611903522f, content=注意高血压患者卒中预防收缩压的控制。, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, 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=Tue Apr 25 07:03:28 CST 2017, time=2017-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185912, encodeId=e987185912fa, content=高血压成年忠者卒中预防收缩压控制的标准。, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, 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=Sat Apr 08 07:30:36 CST 2017, time=2017-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183684, encodeId=a3d918368487, content=成年高血压患者卒中的血压控制。, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36081, encryptionId=35cc36081e2, topicName=卒中预防)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd925339785, createdName=陈吴1236, createdTime=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501123, encodeId=0db31501123cd, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, 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=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=178344, encodeId=87741e8344d2, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed Mar 01 10:22:37 CST 2017, time=2017-03-01, status=1, ipAttribution=)]
    2017-04-25 jyzxjiangqin

    注意高血压患者卒中预防收缩压的控制。

    0

  5. 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36081, encryptionId=35cc36081e2, topicName=卒中预防)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd925339785, createdName=陈吴1236, createdTime=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501123, encodeId=0db31501123cd, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, 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=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=178344, encodeId=87741e8344d2, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed Mar 01 10:22:37 CST 2017, time=2017-03-01, status=1, ipAttribution=)]
    2017-04-08 jyzxjiangqin

    高血压成年忠者卒中预防收缩压控制的标准。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1840302, encodeId=09c118403026c, 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=77, 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=Mon Mar 20 01:03:00 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038591, encodeId=28152038591ff, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36081, encryptionId=35cc36081e2, topicName=卒中预防)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cd925339785, createdName=陈吴1236, createdTime=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501123, encodeId=0db31501123cd, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, 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=Thu Mar 02 11:03:00 CST 2017, time=2017-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=178344, encodeId=87741e8344d2, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed Mar 01 10:22:37 CST 2017, time=2017-03-01, status=1, ipAttribution=)]
    2017-03-30 jyzxjiangqin

    成年高血压患者卒中的血压控制。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1840302, encodeId=09c118403026c, 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=77, 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=Mon Mar 20 01:03:00 CST 2017, time=2017-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038591, encodeId=28152038591ff, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, 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    2017-03-16 jyzxjiangqin

    高血压成年患者卒中预防。

    0

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  9. 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    2017-03-01 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。

    0

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2017年开年,医疗届就发布了很多与高血压相关的重量级研究,梅斯小编整理回顾了1月以来高血压领域十分重要的热点研究,分享给大家,希望一起学习进步。【1】JAHA:高血压严重程度与认知功能障碍有关 大多数高血压患者靶器官损害(HTN)的证据是与肾脏和心脏相关,而对于脑血管和认知功能障碍的研究相对较少。因此,本研究分析了不同阶段的高血压患者与非高血压对照者认知功能改变的差异,并将研究结果

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