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JACC:冠心病患者:舒张压过低 心绞痛的发生率升高?

2018-10-12 徐怀钰 环球医学

2018年9月,发表于《J Am Coll Cardiol》上的一项研究,考察了慢性冠心病(CAD)患者,舒张压较低(DBP)是否与心绞痛风险升高相关。

2018年9月,发表于《J Am Coll Cardiol》上的一项研究,考察了慢性冠心病(CAD)患者,舒张压较低(DBP)是否与心绞痛风险升高相关。

背景:CAD患者,DBP较低与心肌梗死风险增加相关,但其与心绞痛的相关性尚是未知。

目标:本研究旨在调查CAD患者,DBP较低与心绞痛的关系。

方法:这项研究根据来自美国25个心脏病诊所的CAD患者的DBP,评估了心绞痛频率(使用西雅图心绞痛调查问卷-心绞痛频率评分来测量)。采用分层Logistic回归研究DBP和心绞痛的相关性,使用DBP的样条项进行非线性评估。

结果:1259名CAD门诊患者中,411例(33%)前一个月报告了心绞痛,DBP下四分位数发生率较高(40~64 mm Hg:37%)。在未调整模型中,DBP与心绞痛呈J型相关性(p=0.017,非线性p=0.027),随着DBP降低至70~80mm Hg以下时,心绞痛的发生率逐渐增加。在连续调整人口学特征(p=0.002)、合并症(p=0.002)、心率(p=0.002)、收缩压(p=0.046)和抗高血压抗心绞痛药物(p=0.045)之后,这种相关性仍然显着。

结论:在慢性CAD患者中,DBP较低与心绞痛几率增加可能相关。如果这些发现得到证实,建议临床医生在CAD合并心绞痛患者的血压控制上不要过于激进。

原始出处:

Peri-Okonny PA, et al. Low Diastolic Blood Pressure Is Associated With Angina in Patients With Chronic Coronary Artery Disease. J Am Coll Cardiol. 2018 Sep 11;72(11):1227-1232. doi: 10.1016/j.jacc.2018.05.075.

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    2019-03-10 hbwxf
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    2018-10-12 liumin1987

    嗯嗯,学习了。

    0

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