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Eur Heart J:睡眠血压:血管风险的预后标志和预防治疗靶点

2018-08-12 xing.T MedSci原创

由此可见,睡眠SBP是CVD事件中最重要的BP衍生危险因素。此外,治疗诱导的睡眠SBP降低,而不是清醒SBP,是高血压治疗的新目标,需要通过动态监测定期进行患者评估,并与CVD发病率和死亡率的风险显著降低有关。

睡眠时血压(BP)相比于清醒和24小时血压平均值是血管疾病(CVD)事件的一个更强的危险因素,但睡眠时血压作为降低血管疾病风险治疗靶点的潜在作用尚不确定。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在探究CVD风险降低是否与诊室或动态清醒或睡眠BP均值的逐渐减少最相关。

研究人员前瞻性地评估了18078名具有基线动态血压值的正常血压到高血压个体。受试者在纳入时和随访期间(每年一次),连续48小时测量动态血压。

在5.1年中位随访期间,有2311人发生了心血管事件,其中1209例发生了主要结局(CVD死亡、心肌梗死、冠状动脉血运重建、心力衰竭和卒中的复合事件)。睡眠时收缩压(SBP)平均值是主要结局最显著的BP衍生危险因素[风险比为1.29(95%CI)1.22-1.35/SD升高,P<0.001],无论诊室[1.03(0.97-1.09),P=0.32]还是清醒SBP [1.02(0.94-1.10),P=0.68]。最重要的是,在随访期间,睡眠SBP的逐渐降低是无事件生存的最重要标志[每降低SD为0.75(95%CI 0.69-0.82),P<0.001],无论诊室血压 [1.07(0.97-1.17)P=0.18]或清醒SBP平均值[0.96(0.85-1.08),P=0.47] 如何变化。

由此可见,睡眠SBP是CVD事件中最重要的BP衍生危险因素。此外,治疗诱导的睡眠SBP降低,而不是清醒SBP,是高血压治疗的新目标,需要通过动态监测定期进行患者评估,并与CVD发病率和死亡率的风险显著降低有关。

原始出处:


Ramón C Hermida.et al. Asleep blood pressure: significant prognostic marker of vascular risk and therapeutic target for prevention. Eur Heart J.2018. https://doi.org/10.1093/eurheartj/ehy475

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1800763, encodeId=47c11800e63c3, content=<a href='/topic/show?id=4ec0e303365' target=_blank style='color:#2F92EE;'>#睡眠血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73033, encryptionId=4ec0e303365, topicName=睡眠血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Thu Jun 06 23:27:00 CST 2019, time=2019-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895370, encodeId=35c118953e050, content=<a href='/topic/show?id=18ae64e21d3' target=_blank style='color:#2F92EE;'>#治疗靶点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64721, encryptionId=18ae64e21d3, topicName=治疗靶点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80c5136, createdName=drj2003, createdTime=Tue Jan 08 20:27:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820004, encodeId=ba2e1820004f4, content=<a href='/topic/show?id=0b11100190a4' target=_blank style='color:#2F92EE;'>#预后标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100190, encryptionId=0b11100190a4, topicName=预后标志)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6595338, createdName=xuruicheng, createdTime=Wed May 01 23:27:00 CST 2019, time=2019-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082468, encodeId=f4612082468df, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Thu Oct 11 11:27:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344360, encodeId=e6863443601a, content=好好学习认真的学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Mon Sep 10 13:07:35 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356890, encodeId=af15135689025, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562957, encodeId=01b4156295eb9, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=)]
    2018-09-10 zwjnj2

    好好学习认真的学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1800763, encodeId=47c11800e63c3, content=<a href='/topic/show?id=4ec0e303365' target=_blank style='color:#2F92EE;'>#睡眠血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73033, encryptionId=4ec0e303365, topicName=睡眠血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Thu Jun 06 23:27:00 CST 2019, time=2019-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895370, encodeId=35c118953e050, content=<a href='/topic/show?id=18ae64e21d3' target=_blank style='color:#2F92EE;'>#治疗靶点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64721, encryptionId=18ae64e21d3, topicName=治疗靶点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80c5136, createdName=drj2003, createdTime=Tue Jan 08 20:27:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820004, encodeId=ba2e1820004f4, content=<a href='/topic/show?id=0b11100190a4' target=_blank style='color:#2F92EE;'>#预后标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100190, encryptionId=0b11100190a4, topicName=预后标志)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6595338, createdName=xuruicheng, createdTime=Wed May 01 23:27:00 CST 2019, time=2019-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082468, encodeId=f4612082468df, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Thu Oct 11 11:27:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344360, encodeId=e6863443601a, content=好好学习认真的学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Mon Sep 10 13:07:35 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356890, encodeId=af15135689025, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562957, encodeId=01b4156295eb9, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=)]
    2018-08-14 zhaojie88
  7. [GetPortalCommentsPageByObjectIdResponse(id=1800763, encodeId=47c11800e63c3, content=<a href='/topic/show?id=4ec0e303365' target=_blank style='color:#2F92EE;'>#睡眠血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73033, encryptionId=4ec0e303365, topicName=睡眠血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Thu Jun 06 23:27:00 CST 2019, time=2019-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895370, encodeId=35c118953e050, content=<a href='/topic/show?id=18ae64e21d3' target=_blank style='color:#2F92EE;'>#治疗靶点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64721, encryptionId=18ae64e21d3, topicName=治疗靶点)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80c5136, createdName=drj2003, createdTime=Tue Jan 08 20:27:00 CST 2019, time=2019-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820004, encodeId=ba2e1820004f4, content=<a href='/topic/show?id=0b11100190a4' target=_blank style='color:#2F92EE;'>#预后标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100190, encryptionId=0b11100190a4, topicName=预后标志)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6595338, createdName=xuruicheng, createdTime=Wed May 01 23:27:00 CST 2019, time=2019-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082468, encodeId=f4612082468df, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Thu Oct 11 11:27:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344360, encodeId=e6863443601a, content=好好学习认真的学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6DGOvNrRdcib3UmzMgpEQpl0ENSJScphsFtdgfibXX1g1IuEYGCjP23UqCd52TxTpSZibtPiclyusaHicnNXd78alaia19Qy1nAFo18/0, createdBy=50381491660, createdName=zwjnj2, createdTime=Mon Sep 10 13:07:35 CST 2018, time=2018-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356890, encodeId=af15135689025, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562957, encodeId=01b4156295eb9, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Aug 14 03:27:00 CST 2018, time=2018-08-14, status=1, ipAttribution=)]
    2018-08-14 slcumt
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