Cardiovascular Risks Associated With Diastolic Blood Pressure and Isolated Diastolic Hypertension
Cardiovascular Risks Associated With Diastolic Blood Pressure and Isolated Diastolic Hypertension
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与舒张压和单纯舒张期高血压相关的心血管风险。
DOI：
10.1007/s11906-014-0489-x
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发表时间：
2014-11-01
影响因子：
5.6
通讯作者：
Wang, Ji-Guang
中科院分区：
文献类型：
--
作者：
Li, Yan;Wei, Fang-Fei;Wang, Ji-Guang
高血压是心血管并发症的主要可逆危险因素。根据最近的指南，高血压可细分为孤立性舒张期高血压、孤立性收缩期高血压和收缩期和舒张期混合性高血压。在本文中，我们回顾了观察性前瞻性队列研究和基于大规模个体数据的meta分析中心血管结局与舒张压与收缩压、孤立性舒张期高血压与收缩期和混合性高血压的关系。在队列研究中，在诊所或家中或在动态条件下测量血压24小时。为了说明降低舒张压的治疗效果，我们还回顾了舒张期高血压的随机安慰剂对照试验。结论：与测量血压的方法无关，舒张压和收缩压所带来的风险与年龄有关。在年轻人中，舒张压和孤立性舒张性高血压驱动冠状动脉风险，而在老年人中，收缩压是主要的风险指标。随机试验中舒张压降血压治疗的可逆性证实了舒张压高血压是一个必须治疗的危险因素。
Hypertension is a major reversible risk factor for cardiovascular complications. According to recent guidelines, hypertension can be subdivided into isolated diastolic, isolated systolic, and systolic and diastolic mixed hypertension using proposed thresholds of various blood pressure components. In the present article, we reviewed the association of cardiovascular outcomes with diastolic blood pressure versus systolic blood pressure and with isolated diastolic hypertension versus systolic and mixed hypertension in observational prospective cohort studies and large-scale individual data-based meta-analysis. Blood pressure was measured either in the clinic or at home or under ambulatory conditions for 24 h in cohort studies. To illustrate the treatment effect of diastolic blood pressure lowering, we also reviewed randomized placebocontrolled outcome trials in diastolic hypertension. Conclusions: The risks conferred by diastolic and systolic blood pressure, irrespective of the methods of blood pressure measurement, are age-dependent. Diastolic blood pressure and isolated diastolic hypertension drive coronary risk in younger subjects, whereas systolic blood pressure is the predominant risk indicator in older people. Reversibility of the risk by diastolic BP lowering treatment in randomized trials confirms that diastolic hypertension is a risk factor that must be treated.