Benefits and risks of more intensive blood pressure lowering in hypertensive patients of the HOT study with different risk profiles: does a J-shaped curve exist in smokers?
Benefits and risks of more intensive blood pressure lowering in hypertensive patients of the HOT study with different risk profiles: does a J-shaped curve exist in smokers?
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DOI：
10.1097/00004872-200304000-00024
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发表时间：
2003-04-01
影响因子：
4.9
通讯作者：
Wedel, H
中科院分区：
文献类型：
--
作者：
Zanchetti, A;Hansson, L;Wedel, H
背景：高血压最佳治疗(HOT)研究调查了18790名高血压患者，随机分为三个舒张压(DBP)目标(小于或等于90，小于或等于85，小于或等于80 mm Hg)，持续3.8年，发现糖尿病患者亚组中目标DBP越低，心血管事件和死亡率就越显著，显著减少。我们调查了强化降压的益处是否可以推广到其他亚组，以及是否有高血压患者积极降压的风险可能超过益处。方法和结果18790名患者被分层为：全球心血管风险中/高/高-极高；男性/女性；年龄/年轻；当前吸烟者/非吸烟者；更高/更低的血清胆固醇；更高/更低的血肌酐；有/没有糖尿病；有/没有缺血性心脏病(IHD)。对攻击性较弱的目标组(DBP)进行比较
Background The Hypertension Optimal Treatment (HOT) Study investigated 18 790 hypertensives randomized to three diastolic blood pressure (DBP) targets (less than or equal to90, less than or equal to85, less than or equal to80 mmHg) for 3.8 years and found marked, significant reductions in cardiovascular events and mortality the lower the target DBP in the subset of diabetics. We investigated whether the benefits of intensive DBP lowering could be extended to other subgroups, and whether there are hypertensives in whom the risk of aggressive DBP lowering may outnumber the benefits.Methods and results The 18 790 patients were stratified as: medium/high-very high global cardiovascular risk; men/women; older/younger; current smokers/nonsmokers; higher/lower serum cholesterol; higher/lower serum creatinine; with/without diabetes; with/without ischaemic heart disease (IHD). Comparisons were made between the less aggressive target group (DBP