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首页> 外文期刊>Circulation: An Official Journal of the American Heart Association >Different prognostic impact of 24-hour mean blood pressure and pulse pressure on stroke and coronary artery disease in essential hypertension.
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Different prognostic impact of 24-hour mean blood pressure and pulse pressure on stroke and coronary artery disease in essential hypertension.

机译：24小时平均血压和脉压对原发性高血压中风和冠状动脉疾病的不同预后影响。

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BACKGROUND: We tested the hypothesis that the steady and pulsatile components of blood pressure (BP) exert a different influence on coronary artery disease and stroke in subjects with hypertension. METHODS AND RESULTS: We analyzed data on 2311 subjects with essential hypertension. All subjects (mean age 51 years, 47% women) underwent off-therapy 24-hour ambulatory BP monitoring. Over a follow-up period of up to 14 years (mean 4.7 years), there were 132 major cardiac events (1.20 per 100 person-years) and 105 cerebrovascular events (0.90 per 100 person-years). After adjustment for age, sex, diabetes, serum cholesterol, and cigarette smoking (all P<0.01), for each 10 mm Hg increase in 24-hour pulse pressure (PP), there was an independent 35% increase in the risk of cardiac events (95% CI 17% to 55%). Twenty-four-hour mean BP was not a significant predictor of cardiac events after controlling for PP. After adjustment for age, sex, and diabetes (all P<0.05), for every 10 mm Hg increase in 24-hour mean BP, the risk of cerebrovascular events increased by 42% (95% CI 19% to 69%), and 24-hour PP did not yield significance after controlling for 24-hour mean BP. Twenty-four-hour PP was also an independent predictor of fatal cardiac events, and 24-hour mean BP was an independent predictor of fatal cerebrovascular events. CONCLUSIONS: In subjects with predominantly systolic and diastolic hypertension, ambulatory mean BP and PP exert a different predictive effect on the cardiac and cerebrovascular complications. Although PP is the dominant predictor of cardiac events, mean BP is the major independent predictor of cerebrovascular events.
机译：背景：我们检验了以下假设：高血压患者的血压稳定和脉动成分对冠心病和中风的影响不同。方法和结果：我们分析了2311例原发性高血压患者的数据。所有受试者（平均年龄51岁，女性47％）均接受非治疗性24小时动态BP监测。在长达14年（平均4.7年）的随访期间，发生了132次主要心脏事件（每100人年1.20）和105次脑血管事件（每100人年0.90）。在调整了年龄，性别，糖尿病，血清胆固醇和吸烟（所有P <0.01）后，每24小时脉搏压力（PP）的每增加10 mm Hg，心脏疾病的风险就会独立增加35％事件（95％CI 17％至55％）。控制PP后，二十四小时平均血压不是心脏事件的重要预测指标。在调整了年龄，性别和糖尿病后（所有P <0.05），24小时平均BP每增加10 mm Hg，脑血管事件的风险增加42％（95％CI 19％至69％），并且在控制24小时平均BP后，24小时PP没有显着意义。 24小时PP也是致命性心脏事件的独立预测因子，而24小时平均BP是致命性脑血管事件的独立预测因子。结论：在主要为收缩期和舒张期高血压的受试者中，动态平均血压和血压对心脑血管并发症具有不同的预测作用。尽管PP是心脏事件的主要预测因子，但平均BP是脑血管事件的主要独立预测因子。

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