Visit-to-Visit Blood Pressure Variability and Cardiovascular Death in the Systolic Hypertension in the Elderly Program
Visit-to-Visit Blood Pressure Variability and Cardiovascular Death in the Systolic Hypertension in the Elderly Program
复制标题
DOI：
10.1111/jch.12230
复制
发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Davis, Barry R.
中科院分区：
文献类型：
--
作者：
Kostis, John B.;Sedjro, Jeanine E.;Davis, Barry R.
大多数关于就诊间血压变异性与未来不良心血管事件风险增加之间关系的研究都是短期的，很少包括安慰剂组。使用双盲、安慰剂对照的老年收缩期高血压项目的数据，作者使用国家死亡指数对心血管疾病导致的死亡率进行了长达17年的随访。在校正性别、年龄、血清肌酐、糖尿病、体重指数、吸烟状况、左心室衰竭和高密度脂蛋白胆固醇后，访间血压变异性与心血管死亡相关。与安慰剂组相比，积极治疗组的这种关系明显更强。虽然这可能是与就诊变异性无关的所用药物影响的结果，但数据与假设一致，即不一致的依从性导致缺少活性药物剂量可能是就诊变异性与心血管死亡关系的另一个解释。
Most studies of an association of visit-to-visit variability of blood pressure with increased risk of future adverse cardiovascular events are of short duration and rarely include a placebo group. Using data from the double-blind, placebo-controlled Systolic Hypertension in the Elderly Program, the authors examined mortality from cardiovascular causes up to 17 years of follow-up using the National Death Index. Visit-to-visit blood pressure variability was associated with cardiovascular death after adjustment for sex, age, serum creatinine, diabetes, body mass index, smoking status, left ventricular failure, and high-density lipoprotein cholesterol. The relationship was significantly stronger in the active treatment group compared with the placebo group. Although this could be the result of an effect of the medications used unrelated to visit-to-visit variability, the data are compatible with the hypothesis that inconsistent adherence leading to missing active medication doses may be an additional explanation for the relationship of visit-to-visit variability with cardiovascular death.