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ASH 2014:血压访视间变异性增大可增加冠心病、卒中、心力衰竭及全因死亡风险

2014-05-21 国际循环 国际循环

既往研究显示,血压访视间变异性(VVV)增大会增加特定人群卒中、冠心病(CHD)及全因死亡风险,但其对一般人群上述结局及心力衰竭的影响则尚不确定。 研究者美国阿拉巴马大学伯明翰分校的Paul Muntner等人对降压和降脂治疗预防心脏病发作试验(ALLHAT)的24 004例受试者进行中位4.9年的随访,以评估收缩压及舒张压VVV与致死性CHD、非致死性心肌梗死、全因死亡率、卒中及心力衰竭的相关

既往研究显示,血压访视间变异性(VVV)增大会增加特定人群卒中、冠心病(CHD)及全因死亡风险,但其对一般人群上述结局及心力衰竭的影响则尚不确定。

研究者美国阿拉巴马大学伯明翰分校的Paul Muntner等人对降压和降脂治疗预防心脏病发作试验(ALLHAT)的24 004例受试者进行中位4.9年的随访,以评估收缩压及舒张压VVV与致死性CHD、非致死性心肌梗死、全因死亡率、卒中及心力衰竭的相关性。结果显示,以收缩压的标准差(SD)来定义VVV时,收缩压VVV增大可增加各研究结局的发生风险。校正包括平均收缩压在内的多种变量后,与最低五分位距组相比,收缩压VVV最高五分位距组受试者发生致死性CHD或非致死性心肌梗死、卒中、心力衰竭及全因死亡的风险比HR分别为1.37(95%CI:1.10~1.70)、1.45(95%CI:1.05~2.00)、1.36(95%CI:1.05~1.75)和1.65(95%CI:1.39~1.96)。采用独立于均数的SD(SDIM)及平均实际变异性(ARV)定义收缩压的VVV所获得的相关性结果与上述结果相一致。此外,舒张压VVV增大也会显著增加致死性CHD或非致死性心肌梗死、卒中、心力衰竭及全因死亡的发生风险。

综上可见,血压VVV的增大可增加心血管事件及全因死亡的发生风险,亟需开展进一步研究探寻降低血压VVV有效方法并确定降低血压VVV能否独立降低CVD风险。

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    2014-05-23 kksonne
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