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Hypertension:强化血压治疗可降低标准控制血糖的2型糖尿病患者的心血管事件风险

2018-07-06 MedSci MedSci原创

强化血压(BP)治疗是否有助于预防心血管事件,包括2型糖尿病患者的心衰?现有学者对此展开研究。研究人员利用ACCORD BP试验的数据,根据Cox风险率模型计算心血管事件的风险比,对比采取标准疗法(2362人)和强化血糖控制(2371人)的患者首次发生心血管事件的时间。总体平均随访4.5年,随访期间有528位患者确诊发生心血管事件。对于采用标准血糖控制的患者,强化BP治疗组的心血管事件风险明显低于

强化血压(BP)治疗是否有助于预防血管事件,包括2型糖尿病患者的心衰?现有学者对此展开研究。

研究人员利用ACCORD BP试验的数据,根据Cox风险率模型计算心血管事件的风险比,对比采取标准疗法(2362人)和强化血糖控制(2371人)的患者首次发生心血管事件的时间。

总体平均随访4.5年,随访期间有528位患者确诊发生心血管事件。对于采用标准血糖控制的患者,强化BP治疗组的心血管事件风险明显低于标准BP治疗组(风险比0.71;95% CI 0.56-0.90;p=0.005),而对于采用强化血糖控制的患者,标准BP治疗和强化BP治疗组之间的心血管事件风险无显著差异(1.06;95% CI 0.83-1.36;p=0.61)。BP治疗方案和血糖控制之间存在明显交叉(p=0.02)。对于采用标准控制血糖的患者,强化BP治疗可显着降低其中风风险,但对于强化血糖控制的患者,则无此现象。强化血糖控制的患者中,采用强化BP治疗的患者所有原因的死亡率要高于采用标准BP治疗的患者的死亡率(风险比1.38;95% CI 0.99-1.92;p=0.05)。

强化BP治疗的优势仅见于ACCORD BP试验采用标准血糖控制且无其他风险因素的患者。因此,目前尚不能明确强化BP治疗是否可降低心血管事件风险,或许应扩大试验规模进一步确定。

原始出处:

Tetsuro Tsujimoto, Hiroshi Kajio. Benefits of Intensive Blood Pressure Treatment in Patients With Type 2 Diabetes Mellitus Receiving Standard but Not Intensive Glycemic Control. Hypertension.July 02,2018. https://doi.org/10.1161/HYPERTENSIONAHA.118.11408

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    2018-11-14 feather89
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