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Hypertension:主动脉硬化指标预示顽固性高血压患者的结局

2019-03-09 国际循环编辑部 国际循环

目前,关于主动脉硬化指标对顽固性高血压患者预后方面的研究甚少。近期,Hypertension杂志发表了一项相关研究。

目前,关于主动脉硬化指标对顽固性高血压患者预后方面的研究甚少。近期,Hypertension杂志发表了一项相关研究。

研究采用前瞻性队列研究的形式,旨在评估顽固性高血压患者中不良血管事件发生率和死亡率的情况。研究人员纳入891例顽固性高血压患者,平均随访期7.8年,通过测量颈-股动脉脉搏波速(cf-PWV)对其进行基线主动脉硬度评估。研究采取多因素Cox分析的方式,分析cf-PWV与总血管事件(CVE)、总主要不良心血管事件、心血管和全因死亡率之间的关系,使用C统计和综合辨别改善指数评价危险分层的优化程度。随访期间,共出现138例CVE(其中总主要不良心血管事件123例)和142例死亡(其中91例死于心血管疾病)。采用连续变量或分类变量的形式分析cf-PWV,可通过cf-PWV预测所有的心血管和死亡结局。主动脉硬度增加的患者(校正白大衣效应后cf-PWV变为为10 m/s,未经校正的直接测量值为11 m/s),在调整其他危险因素(包括24小时动态血压和血压下降模式)后,患者的CVE和死亡风险显著增加2.2~2.6倍。此外,研究结果显示,主动脉硬化可显著改善患者的心血管危险分层情况,综合辨别改善指数的范围从13%(总CVE)到18%(总主要不良心血管事件)。

因此,研究人员认为,增加主动脉硬度可预测顽固性高血压患者的心血管不良结局和死亡率,并改善其心血管危险分层情况,并建议应将cf-PWV测定纳入顽固性高血压的常规临床治疗中。

原始出处:
Claudia R. L. Cardoso, Guilherme C. Salles. Prognostic Impact of Aortic Stiffness in Patients With Resistant Hypertension: A Prospective Cohort Study. Hypertension. 2019;73:728–735.

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    2019-10-03 feather89
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    2019-08-03 heli0118
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    2019-03-09 一天没事干

    很好的学习机会

    0

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