Prognostic value of ambulatory blood pressure measurements: further analyses.
Prognostic value of ambulatory blood pressure measurements: further analyses.
复制标题
动态血压测量的预后价值：进一步分析。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
Juster Rp
中科院分区：
文献类型：
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作者：
D. Perloff;M. Sokolow;R. Cowan;Juster Rp
对761例接受动态血压监测的高血压患者进行了平均5.5年的随访，研究了动态收缩压作为心血管并发症发生的预测因子的价值。在入组研究时无既往心血管事件的695例患者中，11%随后在随访期间（长达10年）发生了事件，而在102例既往发生心血管事件的患者中，这一比例为48%。对于每例患者，使用患者的诊室收缩压和整个样本的诊室动态血压回归方程计算“预测”动态收缩压。通过从观察到的动态血压中减去预测值，得出每例患者的“残余”动态收缩压，作为无法从诊室压力预测的动态血压部分的测量值。我们使用考克斯比例风险模型分析了以下患者入组时特征对后续心血管事件发生的独立影响：性别、年龄、左心室肥大的ECG证据、高血压性视网膜病变、动态收缩压、诊室收缩压、残余动态收缩压和后续药物治疗。在这两组中，有或无既往心血管事件，女性，年轻患者和那些残余动态收缩压较低的患者往往有更长的生存期，没有新的心血管事件。在既往无心血管事件的组中，较低的诊室收缩压和无左心室肥大的晚期ECG证据也是无事件生存期较长的独立预测因素。（250字处删节）
The value of ambulatory systolic blood pressure as a predictor of the development of cardiovascular complications was investigated in a sample of 761 hypertensive patients who had undergone ambulatory blood pressure monitoring and who were followed for an average of 5.5 years. Of the 695 patients without prior cardiovascular events at entry into the study, 11% subsequently experienced an event during the follow-up period (up to 10 years) compared to 48% of the 102 patients with a prior cardiovascular event. For each patient, a 'predicted' ambulatory systolic blood pressure was calculated, using the patient's office systolic blood pressure and the equation derived from regressing ambulatory on office blood pressure for the entire sample. By subtracting the predicted from the observed ambulatory pressure, a 'residual' ambulatory systolic blood pressure was derived for each patient, as a measure of that portion of the ambulatory pressure that could not be predicted from the office pressure. We used a Cox proportional hazards model to analyse the independent effect of each of the following patient characteristics at entry on the occurrence of subsequent cardiovascular events: sex, age, ECG evidence of left ventricular hypertrophy, hypertensive retinopathy, ambulatory systolic blood pressure, office systolic blood pressure, residual ambulatory systolic blood pressure and subsequent drug therapy. In both groups, with and without a prior cardiovascular event, women, younger patients and those with lower residual ambulatory systolic blood pressure tended to have longer periods of survival without new cardiovascular events. In the group without prior cardiovascular events, a lower office systolic blood pressure and the absence of advanced ECG evidence of left ventricular hypertrophy were also independently predictive of longer event-free survival.(ABSTRACT TRUNCATED AT 250 WORDS)