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Stroke:低血压、合并症与缺血性卒中死亡率的关系

2021-11-03 MedSci原创 MedSci原创

与正常血压相比,卒中前较低的血压与卒中后死亡率相关,尤其是在至少有一种合并症的患者中。

低血压(BP)与卒中患者较高的死亡率相关,尽管尚未充分探讨这种关联的潜在因素。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员在美国退伍军人的全国样本中调查了卒中前血压和缺血性卒中后患者长期死亡率之间的关系。

研究人员对2002年至2007年间首次发生缺血性卒中且在入院前1至18个月内进行1次以上门诊血压测量的退伍军人进行回顾性队列研究,研究人员确定了卒中前收缩压(SBP)和舒张压各6个组别,以及脉压的7个组别。研究人员对患者的全因死亡率和心血管死亡率主要结局进行了长达12年的随访,并使用Cox模型将卒中前血压指标与死亡率相关联,并通过存在的合并症(吸烟、心肌梗死、心力衰竭、心房颤动/扑动、癌症和痴呆)、种族和民族进行了分层分析。

在29690名符合条件的卒中退伍军人(平均±SD年龄为67±12岁,98%为男性,67%为白人)中,2989名(10%)患者的平均卒中前SBP<120mmHg。在4.1±3.3年的随访期间,SBP<120mmHg的患者全因死亡率为61%,心血管死亡率为27%。在多变量分析中,SBP最低、舒张压最低和脉压最高的患者死亡风险最高:SBP<120与130-139mmHg相比(风险比=1.26[95%CI为1.19-1.34]);舒张压<60与70-79mmHg相比(风险比=1.35[95%CI为1.23-1.49]);以及脉压≥90与60-69mmHg相比(风险比=1.24[95%CI为1.15-1.35])。平均SBP<120mmHg且至少有一种合并症(吸烟、心脏病、癌症或痴呆)的患者死亡风险最高(风险比=1.45[95%CI为1.37-1.53])。

与正常血压相比,卒中前较低的血压与卒中后死亡率相关,尤其是在至少有一种合并症的患者中。

原始出处:

Hugo J. Aparicio.et al.Low Blood Pressure, Comorbidities, and Ischemic Stroke Mortality in US Veterans.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033195

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    2021-11-04 查查佳佳

    腰椎骶化及骶椎腰化均是椎骨发育的异

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    2021-11-04 1207866fm50(暂无昵称)

    谢谢分享

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