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Hypertension:24小时平均动脉压与主要心血管不良事件的相关性

2021-01-01 Nebula MedSci原创

《2010年全球疾病负担研究》报告:高血压(BP)是主要的可改变的心血管危险因素,每年造成940万人死亡,即超过心血管死亡率的一半。主要心血管不良事件与24小时血压(BP)密切相关。因此,

《2010年全球疾病负担研究》报告:高血压(BP)是主要的可改变的血管危险因素,每年造成940万人死亡,即超过心血管死亡率的一半。主要心血管不良事件与24小时血压(BP)密切相关。因此,准确测量BP是预防高血压相关心血管并发症的关键

Melgarejo等确定了24小时平均动脉压(MAP,一种用振荡仪评估的BP指数)的结果驱动阈值,还评估了主要心血管不良事件与基于人群的队列(n=11596)的24小时MAP、收缩压(SBP)和舒张压(DBP)的相关性。

办公室和24小时MAP基线平均值分别是97.4和90.4 mmHg。中位随访13.6年以上,共发生了2034例主要心血管不良事件,包括916例冠脉终点和809例卒中终点

与24小时血压相关的主要终点的相对风险比

采用共益程序,研究人员确定了24小时MAP阈值:正常血压:<90 mmHg(n=6183),MAP升高:90~<92 mmHg(n=909)、高血压1期:92~<96 mmHg(n=1544)和高血压2期:≥96 mmHg(n=2960),这些人群的10年主要不良心血管事件风险相当

与24小时平均动脉压、收缩压和舒张压相关的主要终点的10黏附风险预测

与24小时MAP正常血压人群相比,升高的、高血压1期、高血压2期MAP人群主要心血管不良事件的风险比(HR)分别是0.96 (95% CI, 0.80–1.16)、1.32 (1.15–1.51)和1.77 (1.59–1.97)。

考虑到24小时监测,SBP和MAP的R2统计量相近(1.34 vs 1.28),但DBP的R2统计量低于MAP(0.47);而且如果基本模型纳入还纳入了SBP和DBP,R2统计量会减少为零。如果按照2017年美国指南和MAP建议的92 mmHg对MAP进行二分类,R2值则分别为0.71、0.89、0.32和0.10。

总而言之,该研究表明,24小时MAP阈值结合SBP和DBP的临床应用可提高主要心血管不良事件风险评估准确性

原始出处:

Jesus D. Melgarejo, et al. Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. Hypertension. 2021;77:39–48

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    2021-07-09 feather89
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    2021-10-19 chengjn
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1728754, encodeId=a5921e2875488, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Fri Jul 09 03:24:33 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837893, encodeId=ae6c183e893b9, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, 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  6. [GetPortalCommentsPageByObjectIdResponse(id=1728754, encodeId=a5921e2875488, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Fri Jul 09 03:24:33 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837893, encodeId=ae6c183e893b9, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, 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  7. 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CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913024, encodeId=560c91302477, content=动态血压监测,平均压更有估测意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Sat Jan 02 09:10:18 CST 2021, time=2021-01-02, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1728754, encodeId=a5921e2875488, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Fri Jul 09 03:24:33 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837893, encodeId=ae6c183e893b9, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, 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GetPortalCommentsPageByObjectIdResponse(id=913244, encodeId=aa94913244ba, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/kCcPZxo8VtmYhf6icgcOqlZ3zmVPOUCGfwY285BTLw6UJpM6yvRERz9m4icc8icSPaNCzGl6ZLlHibyJ8lIrsiccISw/132, createdBy=ee961608717, createdName=xiaofushi, createdTime=Sun Jan 03 10:42:33 CST 2021, time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913145, encodeId=173791314511, content=已阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201230/ea6e8f75bed34badb45686736e50d717/35fec8cdc1764e2989ef631d7aaa2978.jpg, createdBy=e41c2026322, createdName=rocker, createdTime=Sat Jan 02 20:54:10 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913024, encodeId=560c91302477, content=动态血压监测,平均压更有估测意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Sat Jan 02 09:10:18 CST 2021, time=2021-01-02, status=1, ipAttribution=)]
    2021-01-03 xiaofushi

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1728754, encodeId=a5921e2875488, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, 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=Fri Jul 09 03:24:33 CST 2021, time=2021-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837893, encodeId=ae6c183e893b9, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, 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CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913024, encodeId=560c91302477, content=动态血压监测,平均压更有估测意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Sat Jan 02 09:10:18 CST 2021, time=2021-01-02, status=1, ipAttribution=)]
    2021-01-02 rocker

    已阅读

    0

  10. 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CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913024, encodeId=560c91302477, content=动态血压监测,平均压更有估测意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/27/acbb6b1da577b0f1b1e6528951d0d9ad.jpg, createdBy=cbe71742641, createdName=青荷之约, createdTime=Sat Jan 02 09:10:18 CST 2021, time=2021-01-02, status=1, ipAttribution=)]
    2021-01-02 青荷之约

    动态血压监测,平均压更有估测意义

    0

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