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Hypertension:在日本,晨起在家测量收缩压可以预测卒中发生的风险

2016-06-29 phylis 译 MedSci原创

研究者旨在确定家庭血压(BP)监测最佳的时间,以最好预测卒中和冠状动脉疾病。日本晨起家庭血压(J-HOP)研究是一项全国性基于实践的研究,包括4310具有心血管疾病史或心血管疾病危险因素,或两者均有的日本人(平均年龄65岁;79%用抗高血压的药物)。基线时,超过14天家庭血压监测,每天两次(早晨和晚上)。在平均4年(16929人年)的随访中,74例发生卒中和77例发生冠状动脉疾病。早晨收缩压(SB

研究者旨在确定家庭血压(BP)监测最佳的时间,以最好预测卒中和冠状动脉疾病。日本晨起家庭血压(J-HOP)研究是一项全国性基于实践的研究,包括4310具有心血管疾病史或心血管疾病危险因素,或两者均有的日本人(平均年龄65岁;79%用抗高血压的药物)。

基线时,超过14天家庭血压监测,每天两次(早晨和晚上)。在平均4年(16929人年)的随访中,74例发生卒中和77例发生冠状动脉疾病。早晨收缩压(SBP)对卒中发生的区分度(C统计,0.802;95%CI,0.692-0.911)超过传统的危险因素,包括办公室SBP(0.756;0.646-0.866),而晚上SBP的变化较小(0.764;0.653-0.874)。将晚上SBP添加到模型(包括传统危险因素加上早晨SBP)显著降低卒中发生的区分度(C统计差,-0.008;95%CI:-0.015到-0.008;P = 0.03)。将早晨血压加入模型,无分类净重新分类改善(0.3606;95%可信区间,0.1317-0.5896),绝对综合判别改进(0.015;SE,0.005)以及相对综合判别改进(58.3%)都高于将晚上SBP及晨起和晚上SBP加入模型。早晨和晚上SBP都不能改善冠心病风险预测。

至少在日本,早晨应该测量家庭SBP,以确保最佳卒中预测。这应该在其他的民族群体得到印证。

原始出处:

Hoshide S, Yano Y, Haimoto H, et al. Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population: The Japan Morning Surge-Home Blood Pressure Study. Hypertension. 2016 Ju


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    2016-08-01 feather89
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    2016-09-16 ylzr123

    关注值得学习。赞!好文有待探究。

    0

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    2016-09-10 1e10c84am36(暂无匿称)

    真是好文章,百姓也可以从中学到好多医学知识

    0

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    2016-08-28 ylzr123

    深度好文,值得学习,赞!

    0

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