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JAHA:门诊抗高血压治疗期间左心室肥厚逆转效果如何?

2017-03-13 xing.T MedSci原创

由此可见,早期高血压治疗,积极的血压控制,并注意代谢方面是避免不可逆的LVH的关键所在。

逆转左心室(LV)肥厚(LVH)一直是临床试验的一个目标。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项研究采用三级医疗中心的大型注册数据检验了关于逆转LVH相关临床试验结果的外部效度,以确定不太可能实现LVH逆转的表型。

研究人员纳入了来自于Campania Salute网络的不患有心血管疾病,但心脏超声发现LVH(定义为左室质量指数[LVMi]女性>47g/m2.7,男性>50g/m2.7)的患者。

中位随访时间为67个月,研究人员发现14%的患者被明确证实发生可LVH逆转(初始LVMI减少了13±8%)或当考虑将LVMi降低至≥5g/m2.7时有23%的患者发生了LVH逆转。持续的LVH患者年龄较大,并且高血压病程较长,血压(BP)控制欠佳,体重指数、左室质量与颈动脉内膜中层厚度较大,以及包含更多的女性和糖尿病、单纯收缩期高血压代谢综合征患者(所有P均<0.05)。随访期间,组间抗高血压药物的数量和种类没有差别。多因素Logistic回归分析显示,年龄较大、女性、肥胖、高基础LVMi与颈动脉内膜中层厚度和控制欠佳的血压是持续性显著的协变量(所有P均≤0.01),并且独立于糖尿病、高血压病程、单纯收缩期高血压,随访时间以及降压药物数量和种类。

由此可见,早期高血压治疗,积极的血压控制,并注意代谢方面是避免不可逆的LVH的关键所在。

原始出处:

Mai Tone Lønnebakken,  et al. Left Ventricular Hypertrophy Regression During Antihypertensive Treatment in an Outpatient Clinic (the Campania Salute Network).JAHA.2017.https://doi.org/10.1161/JAHA.116.004152

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    2017-03-15 zhaohui6731
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1632176, encodeId=9eb116321e6c0, content=<a href='/topic/show?id=8f684805678' target=_blank style='color:#2F92EE;'>#左心室肥厚#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48056, encryptionId=8f684805678, topicName=左心室肥厚)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=475421864021, createdName=zll0632, createdTime=Mon Aug 21 22:17:00 CST 2017, time=2017-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1743811, encodeId=dc371e438117e, content=<a href='/topic/show?id=80975584966' target=_blank style='color:#2F92EE;'>#抗高血压治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55849, encryptionId=80975584966, topicName=抗高血压治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4ec35231011, createdName=habb, createdTime=Wed Oct 04 21:17:00 CST 2017, time=2017-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039769, encodeId=c17e2039e69da, content=<a href='/topic/show?id=bf0f5584ef6' target=_blank style='color:#2F92EE;'>#抗高血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55847, encryptionId=bf0f5584ef6, topicName=抗高血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e87531, createdName=klivis, createdTime=Thu Oct 19 05:17:00 CST 2017, time=2017-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1769303, encodeId=af921e693036f, content=<a href='/topic/show?id=ab5a509656a' target=_blank style='color:#2F92EE;'>#心室肥厚#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50965, encryptionId=ab5a509656a, topicName=心室肥厚)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb5738012707, createdName=wjcjjian, createdTime=Fri Jan 12 01:17:00 CST 2018, time=2018-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267400, encodeId=2257126e400eb, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Mar 15 10:17:00 CST 2017, time=2017-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1413186, encodeId=aeb4141318649, content=<a href='/topic/show?id=1d7e48033f5' target=_blank style='color:#2F92EE;'>#左心室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48033, encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Wed Mar 15 10:17:00 CST 2017, time=2017-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179843, encodeId=d1461e9843e7, content=好文章,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28761705280, createdName=cuiyejia, createdTime=Tue Mar 14 13:35:45 CST 2017, time=2017-03-14, status=1, ipAttribution=)]
    2017-03-14 cuiyejia

    好文章,谢谢分享

    0

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