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BMJ:发表中国CDC文章,称80岁后正常血压需要重新界定

2018-06-09 文韬 中国循环杂志

中国CDC一项入选平均年龄92.1岁的高龄老人的研究发现,收缩压129 mmHg者死亡风险最低。收缩压低于107 mmHg人群的全因死亡风险增加8%,高于154 mmHg人群的死亡风险增加27%。

中国CDC一项入选平均年龄92.1岁的高龄老人的研究发现,收缩压129 mmHg者死亡风险最低。收缩压低于107 mmHg人群的全因死亡风险增加8%,高于154 mmHg人群的死亡风险增加27%。

作者称,目前血压“低一点,好一点”的说法不适用于这些老年人,在80岁以后所谓正常血压的概念需要重新界定。

研究共纳入2001名80多岁老人,1832名90多岁老人和825名百岁老人。对这些老人平均随访三年后,共44.2%的老人死亡。

研究还发现,与收缩压107~154 mmHg的老年人相比,>154 mmHg者心血管死亡风险增加51%,<107 mmHg者非心血管死亡风险增加58%。

本次研究为2011-2014年间老年人群健康长寿调查研究的一部分,总计22个省,4658名高龄老年人参与,主要终点是3年随访期间参与者全因死亡以及特异性死亡。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1848534, encodeId=1f361848534f1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 23 19:53:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326925, encodeId=e60a32692577, content=对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Mon Jun 25 16:53:57 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326155, encodeId=04363261558d, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jun 22 18:34:52 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324178, encodeId=44d53241e84c, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 14 19:32:17 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322848, encodeId=db7d32284880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Jun 09 18:57:14 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322832, encodeId=51c73228326f, content=有针对性人群调整血压标准势在必行., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 09 18:05:02 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2019-04-23 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1848534, encodeId=1f361848534f1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 23 19:53:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326925, encodeId=e60a32692577, content=对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Mon Jun 25 16:53:57 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326155, encodeId=04363261558d, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jun 22 18:34:52 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324178, encodeId=44d53241e84c, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 14 19:32:17 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322848, encodeId=db7d32284880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Jun 09 18:57:14 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322832, encodeId=51c73228326f, content=有针对性人群调整血压标准势在必行., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 09 18:05:02 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-25 tjdsyyzg

    对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别.

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1848534, encodeId=1f361848534f1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 23 19:53:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326925, encodeId=e60a32692577, content=对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Mon Jun 25 16:53:57 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326155, encodeId=04363261558d, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jun 22 18:34:52 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324178, encodeId=44d53241e84c, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 14 19:32:17 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322848, encodeId=db7d32284880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Jun 09 18:57:14 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322832, encodeId=51c73228326f, content=有针对性人群调整血压标准势在必行., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 09 18:05:02 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-22 131****1460

    学习了受益匪浅

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1848534, encodeId=1f361848534f1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 23 19:53:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326925, encodeId=e60a32692577, content=对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Mon Jun 25 16:53:57 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326155, encodeId=04363261558d, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jun 22 18:34:52 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324178, encodeId=44d53241e84c, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 14 19:32:17 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322848, encodeId=db7d32284880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Jun 09 18:57:14 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322832, encodeId=51c73228326f, content=有针对性人群调整血压标准势在必行., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 09 18:05:02 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-14 131****1460

    学习了受益匪浅

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1848534, encodeId=1f361848534f1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 23 19:53:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326925, encodeId=e60a32692577, content=对于老年无严重疾患的病人.血压靶目标应该和普通人群无差别., beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7ad162150, createdName=tjdsyyzg, createdTime=Mon Jun 25 16:53:57 CST 2018, time=2018-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=326155, encodeId=04363261558d, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Fri Jun 22 18:34:52 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324178, encodeId=44d53241e84c, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Jun 14 19:32:17 CST 2018, time=2018-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322848, encodeId=db7d32284880, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Jun 09 18:57:14 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322832, encodeId=51c73228326f, content=有针对性人群调整血压标准势在必行., beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Jun 09 18:05:02 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-09 131****1460

    学习了受益匪浅

    0

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    2018-06-09 1e0f8808m18(暂无匿称)

    有针对性人群调整血压标准势在必行.

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急性缺血性卒中RCT汇总分析显示静脉溶栓(IVT)对于年龄>80岁与年龄18-80岁的疗效是相似的。对于3-4.5h的时间窗,年轻患者的获益具有显著性(OR 1.26, 95% CI 1.04–1.54),但是老年患者的获益未达到独立显著性;不过,老年患者的样本量较小,并且显示一定程度获益(OR 1.36, 95% CI 0.87–2.14)。6h内治疗延迟将减弱IVT的获益,并且未相应增加s

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