JAHA:直立性低血压与中老年心血管疾病的临床和亚临床风险!

2018-05-12 xing.T MedSci原创

由此可见,社区中年人OH与未来CVD事件和亚临床CVD有关。进一步的研究是必要的,以明确OH在CVD发病机制中的因果作用。

虽然直立性低血压(OH)是神经病变和低血容量公认的表现,但其对心血管疾病(CVD)风险的影响仍存在争议。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员在ARIC(动脉粥样硬化风险社区)研究(1987 - 1989)第一次访视时确定了OH患者,其定义为从仰卧到站立位血压下降(收缩期超过20mmHg或舒张期超过10mmHg)。所有受试者随访至心肌梗死、心力衰竭、卒中、致死性冠心病(CHD)、任何CHD(静默、非致死性和致命性CHD或心脏手术的组合)以及全因死亡率。参加者在第一次访视期间评估了颈动脉内膜厚度和斑块。在第二次访视(1990~1992)期间测定了血液中高敏肌钙蛋白T(≥5ng/L)和升高的NT-proBNP(B型利钠肽前体N末端,≥100μg/ml)。所有已知的CVD危险因素都被调整。

9139例受试者(女性占57%,黑人占23%,平均年龄为54±5.7岁),3%的受试者存在OH。随访期间(中位时间为26年),OH与心肌梗死(风险比(HR)为1.88;95%可信区间[CI]为1.44 - 2.46)、充血性心力衰竭(HR为1.65,95%CI为1.34-2.04)、卒中(HR为1.83;95%CI为1.35 - 1.35)、致命性CHD(HR为2.77,95%CI为1.93-3.98)、任何CHD(HR为2;95%CI为1.64-2.44)、全因死亡率(HR为1.68;95%CI为1.45-1.95)相关。OH也与颈动脉内膜厚度(β为0.05 mm;95% CI为0.04-0.07 mm)、颈动脉斑块(比值比为1.51,95%CI为1.18-1.93)、可检测的高敏肌钙蛋白T(比值比为1.49;95%CI为1.16-1.93)和升高的NT-proBNP(比值比为1.92,95%CI为1.48-2.49)相关。

由此可见,社区中年人OH与未来CVD事件和亚临床CVD有关。进一步的研究是必要的,以明确OH在CVD发病机制中的因果作用。

原始出处:

Stephen P. Juraschek,et al. Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle‐Aged Adults, JAHA.2018. https://doi.org/10.1161/JAHA.118.008884

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    2018-05-14 仁者大医
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    2018-05-13 121832a9m88暂无昵称

    学习了

    0

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    2018-05-12 smartxiuxiu

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1923781, encodeId=c8681923e8187, content=<a href='/topic/show?id=56a522389f9' target=_blank style='color:#2F92EE;'>#中老年#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22389, encryptionId=56a522389f9, topicName=中老年)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Fri Oct 12 22:39:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267814, encodeId=87a0126e81439, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Mon May 14 02:39:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367369, encodeId=e894136e36995, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Mon May 14 02:39:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422868, encodeId=7c31142286888, content=<a href='/topic/show?id=16d7e24580f' target=_blank style='color:#2F92EE;'>#直立性低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72458, encryptionId=16d7e24580f, topicName=直立性低血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6ab73741511, createdName=chaojitidian, createdTime=Mon May 14 02:39:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498410, encodeId=8f7d14984109c, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon May 14 02:39:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314603, encodeId=b73b31460393, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Sun May 13 06:13:57 CST 2018, time=2018-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314478, encodeId=a05c3144e809, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat May 12 17:31:29 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314459, encodeId=ecc6314459b6, content=好好学习天天向上, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat May 12 15:23:00 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314451, encodeId=bf703144519c, content=值得点赞!认真学习.应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat May 12 14:30:20 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-12 忠诚向上

    好好学习天天向上

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    2018-05-12 虈亣靌

    值得点赞!认真学习.应用于实践!谢谢分享给广大同好!

    0

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