Response by Beddhu et al to Letters Regarding Article, "Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control".
Response by Beddhu et al to Letters Regarding Article, "Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control".
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Beddhu 等人对有关文章“基线舒张压对强化与标准血压控制的影响的影响”的信件的回应。
DOI：
10.1161/circulationaha.118.034738
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发表时间：
2018
期刊：
影响因子：
37.8
通讯作者：
SPRINTResearchGroup
中科院分区：
文献类型：
--
作者：
Beddhu,Srinivasan;Chertow,GlennM;Cheung,AlfredK;Cushman,WilliamC;Greene,Tom;Wei,Guo;Boucher,Robert;Whelton,PaulK;SPRINTResearchGroup
循环。2018;137: 2668 - 2669。DOI: 10.1161 / CIRCULATIONAHA。118.034738 2018年6月12日2669血流量和氧供应随时间的变化。因此，与通常认为低舒张压和基线冠状动脉疾病患者降低收缩压会恶化心肌O2平衡从而导致较差的心血管结果相反，可以想象，在某些人群中，降低收缩压可以保持或改善心肌O2平衡，从而保持甚至增强心脏保护作用。我们警告不要将原发性心血管疾病组合分解为其组成部分，然后在统计能力有限的情况下，将两个随机分组的DBP每五分位数内的每个结果进行比较。尽管如此，在线数据补充1中关于非卒中心血管疾病事件（包括非致死性心肌梗死、不导致心肌梗死的急性冠状动脉综合征、急性失代偿性心力衰竭或心血管疾病死亡）的图II的分析显示，尽管观察到低基线舒张压与这些结果相关，但没有证据表明低基线舒张压改变了强化降舒张压的有益效果。
Circulation. 2018; 137: 2668–2669. DOI: 10.1161/CIRCULATIONAHA. 118.034738 June 12, 2018 2669 blood flow and O2 supply over time. Therefore, contrary to the common belief that lowering SBP in patients with low DBP and baseline coronary artery disease worsens myocardial O2 balance resulting in poorer CV outcomes, it is conceivable that in some populations, lowering SBP preserves or improves myocardial O2 balance, resulting in cardioprotective effects that are either preserved or even accentuated.We caution against deconstructing the primary cardiovascular disease composite into its components and then comparing each outcome within each quintile of DBP by the 2 randomized groups given statistical power limitations. Nonetheless, the analyses of Figure II in the online-only Data Supplement1 on nonstroke cardiovascular disease events (which comprise nonfatal myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, acute decompensated heart failure, or death from cardiovascular disease) show that, although low baseline DBP was observationally associated with these outcomes, there was no evidence that low baseline DBP modified the beneficial effects of intensive SBP lowering.