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BMJ:卒中或TIA史人群不同的收缩压目标(PAST-BP)随机试验

2016-02-27 MedSci MedSci原创

目标:为了评估强化的血压管理目标能否降低常见脑血管疾病人群的血压。 设置:从2009-2011年,在英国99家医院进行开放性随机对照试验。

目标:为了评估强化的血压管理目标能否降低常见脑血管疾病人群的血压。

设置:从2009-2011年,在英国99家医院进行开放性随机对照试验。

受试者:有卒中或短暂性脑缺血发作史,收缩压125mm Hg或更高。

干预:强化血压管理目标为(<130mm Hg或基线小于140mm Hg人群中血压下降10 mm Hg),标准目标组(<140 mm Hg)。除血压不同外,两组人员都以相同的方式积极控制血压,由初级护理团队定期随访。

主要结局:收缩压在基线和12个月时的变化。

结果:529名患者(平均年龄72)入组,强化降压组266人,标准治疗组263人。84名患者在随访期间退出(强化组52人,标准组32人)。强化组平均收缩压降低16.1mm Hg,到达127.4 mm Hg,标准组平均降低12.8mm Hg,到达129.4mm Hg。(组间差异2.9mm Hg(95%CI 0.2-5.7),P=0.03)。

结论:脑血管疾病患者血压管理目标为130mm Hg时,较140mm Hg可使血压有额外的小降低。使用收缩压<140mm Hg的目标值积极管理血压对临床降压有重要意义。

原始出处:

BMJ 2016; 352 ,25 February 2016;352:i708

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