短期和中期血压变化与长期死亡率。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
David Steinsaltz PhD , Hamish Patten PhD , Dirk Bester PhD , David Rehkopf PhD
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引用次数: 0

摘要

直到最近,人们还在重点探索平均血压对死亡风险的影响。除了平均血压,我们还研究了血压在两个时间尺度上的变化对死亡风险的影响--一次就诊时多个测量值之间的短期变化,以及相隔数月两次就诊时测量值之间的中期变化。我们将贝叶斯层次模型应用于估计血压(BP)变化对全因死亡率和心血管(CV)死亡率的影响。我们使用了与长达 27 年的死亡率跟踪调查相关联的第三次全国健康与营养调查的数据。我们发现,中期收缩压变异性对心血管疾病和全因死亡率具有非常显著的预测价值,约为已证实的平均收缩压影响的三分之一。中期舒张压变异性也有额外的预测作用,但影响较小。另一方面,短期变异性几乎没有可测量的预测价值。在控制弗雷明汉风险评分后,中期变异性效应依然存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-Term and Mid-Term Blood Pressure Variability and Long-Term Mortality
Until recently, there has been a focus on exploring the influence of average blood pressure (BP) on risk of mortality. We go beyond average BP to also investigate mortality risk with respect to variation in BP over 2 timescales—short-term variation among multiple measures at 1 visit, and medium-term variation among the measures at 2 visits several months apart. We present an application of Bayesian hierarchical modeling to the problem of estimating the effect of BP variability on all-cause and cardiovascular mortality. We use data from the Third National Health and Nutrition Examination Survey linked with up to 27 years of mortality follow-up. We find that medium-term systolic BP variability had a very significant predictive value for all-cause mortality in addition to mortality from cardiovascular disease, cerebrovascular disease and heart-attacks combined, approximately 1/3 as large as the well-established impact of mean systolic BP. Medium-term diastolic variability had an additional, although smaller, predictive effect. Short-term variability, in contrast, had little or no measurable predictive value. The medium-term variability effect persisted when controlling for Framingham Risk Score.
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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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