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家庭血压和办公室血压是普通人群心血管病风险的强预测因子
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Home and office BP predict CV risk in general population 18 July 2007 MedWire News: Both home blood pressure (HBP) and office BP (OBP) are significant predictors of cardiovascular (CV) risk in the general population, Greek researchers report. HBP is increasingly being used in clinical practice, but no extra prognostic value of this measure was found in the current study, report George Stergiou (Sotiria Hospital, Athens) and colleagues. The team invited all adults living in the Didima area in Greece to participate in a cross-sectional study involving two visits to their doctor’s office for OBP measurements to be taken, and HBP measurement on 3 days. A total of 662 individuals, with a mean age of 54 years, participated. During an average 8.2-year follow-up, 78 deaths, of which 42 had a CV cause, and 67 CV events occurred. The unadjusted hazard ratios (HR) for CV events per 1 mmHg increase in systolic HBP and diastolic HBP were 1.034 (p<0.001) and 1.037 (p<0.01), respectively. The corresponding HRs for OBP were 1.035 (p<0.001) and 1.021 (p=0.07). After adjustment for all available CV risk predictors, only diastolic OBP remained a significant predictor for CV events, however. And the addition of HBP did not significantly improve the predictive ability of the risk model including OBP, which the authors say is in contrast to previous study findings. The authors conclude that the study “adds to the evidence showing that HBP has strong prognostic value.” They comment that the available evidence for the prognostic value of HBP is still weak because all except one published outcome studies have been based on relatively small numbers of events. “Thus more and larger studies are needed, particularly for the assessment of the prognostic value of white-coat and masked hypertension phenomena detected by HBP monitoring,” Stergiou et al write in the Journal of Hypertension. J Hypertens 2007; 25: 1590-1596 据MedWire消息：希腊研究者称家庭血压和办公室血压是普通人群心血管病风险的强预测因子。 George Stergiou (Sotiria Hospital, Athens) and colleagues报道家庭血压一直被用作临床实践中，但是在目前研究中没有更多的标准预测值被发现。 这个团队邀请了所有住在希腊Didima地区的成年人去参加一个抽样调查研究，他们在医生的办公室被分为两组，一组为办公室血压测量，一组为家庭血压测量，为期3天。一共有662人参加，平均年龄54.在8.2年的跟中调查中，78个死亡，其中42个有心血管病因，67个有存在心血管疾病。在家庭血压测量收缩压和舒张压中，心血管压力每增加1mmHg,未经校正的危险比率分别是1.034 (p<0.001) 和 1.037 (p<0.01)。在有效的心血管病风险预测因子校正之后，可是只有舒张压的办公室血压变为心血管事件的强预测因子。还有额外的家庭血压没有很大的改善风险模型的推测能力，包括办公室血压，作者所说的这些是与先前的研究结果作对比。 作者对这个研究的结论“增加证据说明家庭血压有很强的预测价值。” 他们评价到家庭血压预测值的有效证据还是不够的，因为除了一人发表的研究结果外，所有的都基于相对小事件 “因此,有越来越多的研究是必需的，特别是家庭血压检测的高血压现象被伪装评成估预后价值。” Stergiou et al发表在高血压杂志。 |
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