高血压患者目标范围内长期收缩压时间与心血管疾病

Zhenyu Huo MD , Shouling Wu MD , Liuxin Li MD , Jingdi Zhang MD , Yang Liu MD , Xu Han MD , Shuohua Chen MD , Guodong Wang MD , Yun Li PhD , Shunming Zhang PhD , Yan Borné PhD , Tingting Geng PhD , Zhe Huang MD
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引用次数: 0

摘要

背景:先前对临床试验的事后分析表明,收缩压在目标范围内的时间(SBP-TTR)百分比较高与心血管疾病(CVD)风险降低相关。然而,关于长期SBP-TTR与心血管疾病风险之间关系的大型前瞻性队列研究证据有限。目的:本研究的目的是评估成人高血压患者长期SBP-TTR与CVD风险之间的关系。方法:纳入26929例高血压患者(平均年龄52.8±10.7岁;83.1%男性),开滦研究基线时无心血管疾病。2006 - 2012年每两年测量一次血压,收缩压目标范围为120 ~ 140 mm Hg, SBP- ttr采用Rosendaal线性插值法计算。通过电子健康记录数据的链接确定突发心血管事件。结果:在8.6年的中位随访期间,记录了2565例心血管疾病,包括472例心肌梗死和2151例中风。将高SBP-TTR(75%-100%)组与低SBP-TTR(0%-25%)组进行比较,心血管疾病的多变量hr为0.67 (95% CI: 0.59-0.76),心肌梗死的多变量hr为0.76 (95% CI: 0.56-1.02),卒中的多变量hr为0.64 (95% CI: 0.56-0.74)。此外,SBP-TTR与CVD风险之间的关联在年龄较大的个体中更强。结论:高血压患者中SBP-TTR百分比较高与CVD风险较低相关。这些发现强调了维持收缩压在目标范围内对高血压患者预防心血管疾病的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Systolic Blood Pressure Time in Target Range and Cardiovascular Disease in Individuals With Hypertension

Background

Previous post hoc analyses of clinical trials have suggested that a higher percentage of systolic blood pressure time in target range (SBP-TTR) was associated with a decreased risk of cardiovascular disease (CVD). However, there is limited evidence from large prospective cohort studies on the relationship between long-term SBP-TTR and the risk of CVD.

Objectives

The purpose of this study was to assess the association between long-term SBP-TTR and the risk of CVD in adults with hypertension.

Methods

This study included 26,929 hypertensive patients (mean age 52.8 ± 10.7 years; 83.1% males), free of CVD at baseline from the Kailuan Study. Blood pressure was measured biennially from 2006 to 2012, and the SBP target range was defined as 120 to 140 mm Hg. SBP-TTR was calculated by the Rosendaal linear interpolation method. Incident CVD events were ascertained via the linkage of electronic health record data.

Results

During a median follow-up of 8.6 years, 2,565 CVD, including 472 myocardial infarction and 2,151 stroke cases were documented. Comparing the high SBP-TTR (75%-100%) with the low SBP-TTR (0%-25%) group, the multivariable HRs were 0.67 (95% CI: 0.59-0.76) for CVD, 0.76 (95% CI: 0.56-1.02) for myocardial infarction, and 0.64 (95% CI: 0.56-0.74) for stroke. In addition, the association between SBP-TTR and CVD risk was stronger among individuals aged <65 years than their older counterparts (P for interaction <0.001).

Conclusions

A greater percentage of SBP-TTR was associated with a lower risk of CVD among patients with hypertension. These findings underscore the importance of maintaining SBP within the target range for the prevention of CVD among hypertensive individuals.
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JACC advances
JACC advances Cardiology and Cardiovascular Medicine
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1.90
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