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Hypertension:血清镁与高血压和慢性肾脏疾病进展风险的关系

2021-11-05 MedSci原创 MedSci原创

在CKD患者中,较高的血清镁与较低的SBP和DBP以及较低的高血压和CKD进展风险相关。在CKD患者中,补充镁是否可以优化血压控制并防止疾病进展值得进一步研究。

慢性肾病 (CKD) 是众所周知的公共卫生问题,在美国影响约3400万成年人,占美国人口的14%以上。有研究报道镁离子参与了血压(BP)调节。血清镁异常在慢性肾脏病(CKD)患者中很常见,但其与CKD患者高血压和CKD进展之间的关联尚未明确。

近日,血管权威杂志Hypertension上发表了一篇研究文章,研究人员分析了来自慢性肾功能不全队列(CRIC研究)的3866名参与者的数据。线性回归评估了血清镁与基线收缩压(SBP)和舒张压(DBP)之间的关联。研究人员采用Logistic回归探讨了血清镁与各种高血压之间的关联,并采用Cox比例风险模型评估了高血压与CKD进展风险的关系。

受试者平均血清镁水平为2.0mEq/L(±0.3mEq/L)。较高的镁水平与较低的SBP(-3.4mmHg[95%CI为-5.8至-1.0每1mEq/L])和较低的DBP(-2.9mmHg[95%CI为-4.3至-1.5每1mEq/L])相关。较高的镁水平与基线时根据美国心脏协会定义的高血压(SBP≥130mmHg或DBP≥80mmHg)较低风险相关(调整后的风险比为0.65[95%CI为0.49-0.86/1mEq/L]),以及与较低的血压控制不佳风险(SBP≥120mmHg或DBP≥80mmHg;调整后的比值比为0.58[95%CI为0.43-0.78每1mEq/L])相关。

在事件时间分析中,较高的基线血清镁与较低的根据CRIC定义的高血压事件风险相关(调整后的风险比为0.77[95%CI为0.46-1.31/1mEq/L])。较高的镁水平与CKD进展的风险显著降低相关(调整后的风险比为0.68[95%CI为0.54-0.86每1mEq/L])。

由此可见,在CKD患者中,较高的血清镁与较低的SBP和DBP以及较低的高血压和CKD进展风险相关。在CKD患者中,补充镁是否可以优化血压控制并防止疾病进展值得进一步研究。

原始出处:

Simon Correa.et al.Serum Magnesium, Blood Pressure, and Risk of Hypertension and Chronic Kidney Disease Progression in the CRIC Study.Hypertension.2021.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.17694

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