Journal of Human Hypertension最新文献_第10页

Efficacy and safety of mineralocorticoid receptor antagonists for the treatment of low-renin hypertension: a systematic review and meta-analysis 矿物皮质激素受体拮抗剂治疗低肾素高血压的有效性和安全性：系统回顾和荟萃分析。

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-11 DOI: 10.1038/s41371-023-00891-1

Sonali S. Shah, Jinghong Zhang, Stella May Gwini, Morag J. Young, Peter J. Fuller, Jun Yang

Hypertension is the leading risk factor for premature death. The optimal treatment of low-renin hypertension (LRH), present in 30% of hypertensive individuals, is not known. LRH likely reflects a state of excess salt, expanded volume and/or mineralocorticoid receptor (MR) activation. Therefore, targeted treatment with MR antagonists (MRA) may be beneficial. The objective of this systematic review was to assess the efficacy of MRA therapy in LRH. MEDLINE, Embase and Cochrane databases were searched for randomised controlled trials of adults with LRH that compared the efficacy of MRA to placebo or other antihypertensive treatments. Risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis was performed using a random-effects model to estimate the difference in blood pressure and the certainty of evidence was assessed using the GRADE approach. The protocol is registered on PROSPERO (CRD42022318763). From the 1612 records identified, 17 studies met the inclusion criteria with a total sample size of 1043 participants. Seven studies (n = 345) were assessed as having a high risk of bias. Meta-analysis indicated that MRA reduced systolic blood pressure by −6.8 mmHg (95% confidence interval −9.6 to −4.1) and −4.8 mmHg (95% confidence interval −11.9 to 2.4) compared to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) and diuretics. The certainty of the evidence was assessed as moderate and very low, respectively. The findings of this systematic review suggest that MRA is effective in lowering blood pressure in LRH and may be better than ACEi/ARB. Translation to clinical practice is limited by the uncertainty of evidence.

高血压是导致过早死亡的首要风险因素。30%的高血压患者存在低肾素高血压（LRH），其最佳治疗方法尚不清楚。低肾素高血压可能反映了盐分过多、血容量增加和/或矿质皮质激素受体（MR）激活的状态。因此，使用 MR 拮抗剂 (MRA) 进行有针对性的治疗可能是有益的。本系统综述旨在评估 MRA 治疗 LRH 的疗效。在 MEDLINE、Embase 和 Cochrane 数据库中检索了针对成人 LRH 患者的随机对照试验，这些试验比较了 MRA 与安慰剂或其他降压治疗的疗效。使用 Cochrane 偏倚风险工具对偏倚风险进行了评估。使用随机效应模型进行荟萃分析，以估算血压差异，并使用 GRADE 方法评估证据的确定性。该研究方案已在 PROSPERO（CRD42022318763）上注册。在已确定的 1612 条记录中，有 17 项研究符合纳入标准，总样本量为 1043 人。七项研究（n = 345）被评估为偏倚风险较高。Meta 分析表明，与血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEi/ARB）和利尿剂相比，MRA 可使收缩压分别降低 -6.8 mmHg（95% 置信区间为 -9.6 至 -4.1）和 -4.8 mmHg（95% 置信区间为 -11.9 至 2.4）。证据的确定性分别被评定为中度和极低。本系统综述的结果表明，MRA 可有效降低 LRH 患者的血压，其效果可能优于 ACEi/ARB。由于证据的不确定性，其在临床实践中的应用受到了限制。

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引用次数: 0

Prognostic utility of rhythmic components in 24-h ambulatory blood pressure monitoring for the risk stratification of chronic kidney disease patients with cardiovascular co-morbidity 24 小时动态血压监测中的节律成分在对合并心血管疾病的慢性肾病患者进行风险分层时的预后作用

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-11 DOI: 10.1038/s41371-023-00884-0

Nadim El Jamal, Thomas G. Brooks, Jordana Cohen, Raymond R. Townsend, Giselle Rodriguez de Sosa, Vallabh Shah, Chronic Renal Insufficiency Cohort Study (CRIC) Consortium, Robert G. Nelson, Paul E. Drawz, Panduranga Rao, Zeenat Bhat, Alexander Chang, Wei Yang, Garret A. FitzGerald, Carsten Skarke

Chronic kidney disease (CKD) represents a significant global burden. Hypertension is a modifiable risk factor for rapid progression of CKD. We extend the risk stratification by introducing the non-parametric determination of rhythmic components in 24-h profiles of ambulatory blood pressure monitoring (ABPM) in the Chronic Renal Insufficiency Cohort (CRIC) and the African American Study for Kidney Disease and Hypertension (AASK) cohort using Cox proportional hazards models. We find that rhythmic profiling of BP through JTK_CYCLE analysis identifies subgroups of CRIC participants that were more likely to die due to cardiovascular causes. While our fully adjusted model shows a trend towards a significant association between absent cyclic components and cardiovascular death in the full CRIC cohort (HR: 1.71,95% CI: 0.99–2.97, p = 0.056), CRIC participants with a history of cardiovascular disease (CVD) and absent cyclic components in their BP profile had at any time a 3.4-times higher risk of cardiovascular death than CVD patients with cyclic components present in their BP profile (HR: 3.37, 95% CI: 1.45–7.87, p = 0.005). This increased risk was not explained by the dipping or non-dipping pattern in ABPM. Due to the large differences in patient characteristics, the results do not replicate in the AASK cohort. This study suggests rhythmic blood pressure components as a potential novel biomarker to unmask excess risk among CKD patients with prior cardiovascular disease.

慢性肾脏病（CKD）给全球带来沉重负担。高血压是导致 CKD 快速恶化的一个可改变的风险因素。我们通过使用 Cox 比例危险模型，在慢性肾功能不全队列（CRIC）和非裔美国人肾脏病和高血压研究（AASK）队列中，采用非参数方法确定非卧床血压监测（ABPM）24 小时曲线中的节律成分，从而扩展了风险分层。我们发现，通过 JTK_CYCLE 分析对血压进行节律性分析，可以发现 CRIC 参与者中更有可能死于心血管疾病的亚组。我们的完全调整模型显示，在整个 CRIC 队列中，不存在周期性成分与心血管死亡之间存在显著联系（HR：1.71,95% CI：0.99-2.97, p = 0.056）。056），有心血管疾病（CVD）病史且血压曲线中不存在循环成分的 CRIC 参与者在任何时候的心血管死亡风险都比血压曲线中存在循环成分的 CVD 患者高 3.4 倍（HR：3.37，95% CI：1.45-7.87，p = 0.005）。ABPM 中的浸渍或非浸渍模式无法解释风险增加的原因。由于患者特征差异较大，研究结果无法在 AASK 队列中复制。这项研究表明，节律性血压成分是一种潜在的新型生物标记物，可揭示既往患有心血管疾病的慢性肾脏病患者的超常风险。

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引用次数: 0

Association between infertility treatment and hypertensive disorders of pregnancy in the Japan Birth Cohort Consortium: a meta-analysis 日本出生队列联合会的不孕症治疗与妊娠高血压疾病之间的关系：一项荟萃分析。

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-10 DOI: 10.1038/s41371-023-00890-2

Mami Ishikuro, Tomoko Nishimura, Hiroyoshi Iwata, Hirohito Metoki, Taku Obara, Noriyuki Iwama, Keiko Murakami, Md. Shafiur Rahman, Maki Tojo, Sumitaka Kobayashi, Chihiro Miyashita, Keiko Tanaka, Yoshihiro Miyake, Kazue Ishitsuka, Reiko Horikawa, Naho Morisaki, Midori Yamamoto, Kenichi Sakurai, Chisato Mori, Atsushi Shimizu, Fumihiro Sata, Kenji J. Tsuchiya, Reiko Kishi, Shinichi Kuriyama, the Japan Birth Cohort Consortium

引用次数: 0

Adult hypertension referral pathway and therapeutic management: British and Irish Hypertension Society position statement 成人高血压转诊途径和治疗管理：英国和爱尔兰高血压学会立场声明。

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-09 DOI: 10.1038/s41371-023-00882-2

Philip Lewis, Jacob George, Vikas Kapil, Neil R. Poulter, Sarah Partridge, James Goodman, Luca Faconti, Terry McCormack, Ian B. Wilkinson

In the UK, most adults with hypertension are managed in Primary Care. Referrals to Secondary Care Hypertension Specialists are targeted to patients in whom further investigations are likely to change management decisions. In this position statement the British and Irish Hypertension Society provide clinicians with a framework for referring patients to Hypertension Specialists. Additional therapeutic advice is provided to optimise patient management whilst awaiting specialist review. Our aim is to ensure that referral criteria to Hypertension Specialists are consistent across the UK and Ireland to ensure equitable access for all patients.

在英国，大多数成人高血压患者都在初级医疗机构接受治疗。转诊至二级医疗机构高血压专科医生的目标是那些通过进一步检查有可能改变治疗决定的患者。在这份立场声明中，英国和爱尔兰高血压学会为临床医生提供了将患者转诊至高血压专科医生的框架。在等待专科医生复查期间，我们将提供额外的治疗建议，以优化患者管理。我们的目标是确保英国和爱尔兰高血压专科医生的转诊标准一致，以确保所有患者都能公平就诊。

引用次数: 0

Efficacy and safety of esaxerenone (CS-3150) in primary hypertension: a meta-analysis 埃沙塞酮（CS-3150）对原发性高血压的疗效和安全性：一项荟萃分析。

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-04 DOI: 10.1038/s41371-023-00889-9

Ran Sun, Yali Li, Lei Lv, Weiliang Zhang, Xiaoxia Guo

This study aimed to assess the efficacy and safety of esaxerenone (CS-3150) in treating primary hypertension. PubMed (Medline), Cochrane Central Register of Controlled Trials (CENTRAL), and Embase databases were searched for articles published until April 18, 2023. The outcomes included were diastolic blood pressure (DBP), systolic blood pressure (SBP), 24 h DBP, 24 h SBP, and adverse events. The meta-analysis was conducted using RevMan 5.3. This study included three trials. CS-3150 5 mg had a greater effect on lowering the SBP, DBP, 24 h SBP, and 24 h DBP than either CS-3150 2.5 mg or eplerenone 50 mg. In contrast, CS-3150 2.5 mg and eplerenone 50 mg showed no significant difference in lowering DBP, SBP, 24 h DBP, and 24 h SBP. Moreover, adverse events occurred at comparable rates in the three groups. CS-3150 (especially CS-3150 5 mg) is an effective and safe treatment for primary hypertension; which can reduce blood pressure and alleviate hypertensive symptoms.

本研究旨在评估埃沙塞酮（CS-3150）治疗原发性高血压的疗效和安全性。研究人员在PubMed（Medline）、Cochrane对照试验中央注册中心（CENTRAL）和Embase数据库中检索了截至2023年4月18日发表的文章。结果包括舒张压 (DBP)、收缩压 (SBP)、24 h DBP、24 h SBP 和不良事件。荟萃分析使用 RevMan 5.3 进行。该研究包括三项试验。与 CS-3150 2.5 毫克或依普利酮 50 毫克相比，CS-3150 5 毫克对降低 SBP、DBP、24 小时 SBP 和 24 小时 DBP 的效果更好。相比之下，CS-3150 2.5 毫克和依普利酮 50 毫克在降低 DBP、SBP、24 小时 DBP 和 24 小时 SBP 方面没有显著差异。此外，三组的不良反应发生率相当。CS-3150（尤其是 CS-3150 5 毫克）是一种有效、安全的原发性高血压治疗药物，可降低血压并缓解高血压症状。

引用次数: 0

Trends in antihypertensive use among privately insured hypertensive clients in Ghana 加纳私人投保的高血压患者使用降压药的趋势

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2024-01-02 DOI: 10.1038/s41371-023-00885-z

Afia Frimpomaa Asare Marfo, John Serbe Marfo, Jacob Plange-Rhule, Samantha Hollingworth

The objective of the study was to describe the patterns of antihypertensive medicines (AHM) in a selected national population in Ghana. The claims data for all privately insured patients in Ghana over three years to 2018 were analysed. The classes of medicines used, the dose by time, gender and age, and generic status were examined. In addition, the use in Defined Daily Dose (DDD) per 1000 population per day was estimated. Classes of AHM prescribed were CCB, ARB, ACEI, diuretics, and BB. Amlodipine, nifedipine, losartan, lisinopril, and bendroflumethiazide accounted for 74% of all use. The most widely used single CCB was amlodipine 3.92 DDD/1,000 population/day in 2016, 3.92 DDD/1,000 population/day in 2017, and 4.92 DDD/1,000 population/day in 2018. In those aged 51–60 years, use of CCB in women (74.0 DDD/1,000 population/day) was almost twice that of men (38.3 DDD/1,000 population/day). The top ten medicines accounted for 93% of all single medicine products in 2018. Most single medicine products was generic (76.5% in 2016; 79.9% in 2017 and 83.1% in 2018) whiles most fixed combination products were branded (73.0% in 2016; 89.7% in 2017 and 91.3% in 2018). The patterns of AHM use are clinically expected although the Ghana Standard Treatment guidelines are not directive about lines of treatment.

本研究旨在描述加纳选定的全国人口中抗高血压药物（AHM）的使用模式。研究分析了截至 2018 年的三年内加纳所有私人投保患者的理赔数据。研究了所用药物的类别、按时间、性别和年龄划分的剂量以及非专利药情况。此外，还估算了每千人每日定义日剂量（DDD）的使用情况。处方的 AHM 类别包括 CCB、ARB、ACEI、利尿剂和 BB。氨氯地平、硝苯地平、洛沙坦、利辛普利和苄氟噻嗪占总用量的 74%。使用最广泛的单一CCB是氨氯地平，2016年为3.92DD/1,000人口/天，2017年为3.92DDD/1,000人口/天，2018年为4.92DDD/1,000人口/天。在 51-60 岁人群中，女性 CCB 使用量（74.0 DDD/1,000 人/天）几乎是男性（38.3 DDD/1,000 人/天）的两倍。2018 年，前十大药品占所有单药产品的 93%。大多数单药产品为仿制药（2016 年为 76.5%；2017 年为 79.9%，2018 年为 83.1%），而大多数固定复方产品为品牌药（2016 年为 73.0%；2017 年为 89.7%，2018 年为 91.3%）。尽管加纳标准治疗指南并未对治疗方案做出指示，但AHM的使用模式符合临床预期。

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引用次数: 0

Application value of serum S100B combined with glucose metabolism indexes in predicting adverse pregnancy outcomes of patients with severe preeclampsia 血清 S100B 结合糖代谢指标在预测重度子痫前期患者不良妊娠结局中的应用价值

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2023-12-30 DOI: 10.1038/s41371-023-00887-x

Aiqin Yan

S100 calcium-binding protein B (S100B) and glucose control are reflective of maternal-fetal risks. We investigated the value of serum S100B combined with fasting blood glucose (FBG)/hemoglobin A1c (HbA1c) in evaluating the pregnancy outcomes of patients with severe preeclampsia (SPE). The clinical characteristics of SPE patients/controls were collected. FBG/HbA1c and serum S100B levels were measured, with their correlations analyzed. SPE patients were subdivided into adverse/non-adverse outcome groups based on follow-up results. The value of different indexes in predicting pregnancy outcomes was analyzed. SPE patients showed higher systolic blood pressure, diastolic blood pressure, urine protein, and body mass index and lower platelets, gestational age at delivery, and infant birth weight than healthy controls. FBG and HbA1c were positively correlated with serum S100B. SPE patients with adverse outcomes exhibited increased serum S100B and FBG/HbA1c levels. The area under the curve of serum S100B + FBG/HbA1c in evaluating adverse pregnancy outcomes of SPE patients was 0.8412 (77.05% sensitivity/84.21% specificity), higher than either alone. Serum S100B and FBG/HbA1c were independent risk factors for adverse outcomes of SPE patients. Overall, serum S100B positively-correlates with FBG/HbA1c in SPE patients. Serum S100B and FBG/HbA1c are independent risk factors, and their combination has high value on predicting adverse pregnancy outcomes of SPE patients.

S100钙结合蛋白B（S100B）和血糖控制可反映母胎风险。我们研究了血清 S100B 结合空腹血糖（FBG）/血红蛋白 A1c（HbA1c）在评估重度子痫前期（SPE）患者妊娠结局中的价值。收集了 SPE 患者/对照组的临床特征。测量FBG/HbA1c和血清S100B水平，并分析其相关性。根据随访结果将 SPE 患者细分为不良/非不良结局组。分析了不同指标在预测妊娠结局方面的价值。与健康对照组相比，SPE 患者的收缩压、舒张压、尿蛋白和体重指数较高，血小板、胎龄和婴儿出生体重较低。FBG 和 HbA1c 与血清 S100B 呈正相关。出现不良预后的 SPE 患者的血清 S100B 和 FBG/HbA1c 水平均有所升高。在评估 SPE 患者的不良妊娠结局时，血清 S100B + FBG/HbA1c 的曲线下面积为 0.8412（灵敏度为 77.05%，特异度为 84.21%），高于单独使用其中一项的结果。血清 S100B 和 FBG/HbA1c 是 SPE 患者不良妊娠结局的独立风险因素。总体而言，SPE 患者的血清 S100B 与 FBG/HbA1c 呈正相关。血清 S100B 和 FBG/HbA1c 是独立的风险因素，它们的组合对预测 SPE 患者的不良妊娠结局具有很高的价值。

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引用次数: 0

Inter-arm blood pressure difference in post-stroke patients with hemiparesis 中风后偏瘫患者手臂间的血压差异。

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2023-12-27 DOI: 10.1038/s41371-023-00886-y

Hai-ping PENG, Liang TAO, Min TANG, Hai SU

The aim of this study was to investigate that inter-arm blood pressure (BP) difference (IAD) and reference arm in 420 post-stroke patients with hemiparesis. Synchronous bilateral-arm BP was measured with two automatic BP devices, and the systolic BP difference of ≥10 mm Hg was recorded as increased sIAD. The arm with higher systolic BP (SBP) was assigned as the reference arm. Our results showed that the prevalence of sIAD was 18.1% in the total group. The paretic arms had similar mean SBP levels (133.6±18.4 vs. 133.8±18.4 mm Hg, NS) and DBP (77.8±11.5 vs. 77.2±10.9 mm Hg, NS) as compared with the unaffected arms. The detection rate of hypertension or uncontrolled hypertension on the SBP values of the reference arm was higher than that on the unaffected arm (41.8% vs. 36.3%). It is concluded that in the post-stroke patients with hemiparesis in the rehabilitation period, the prevalence of sIAD ≥10 mmHg was relatively higher, and using the unaffected arm, rather than the unaffected arm, for BP measurement could induce correctly detection of hypertension.

本研究旨在调查 420 名中风后偏瘫患者的臂间血压（BP）差（IAD）和参考臂。使用两台自动血压仪同步测量双臂血压，将收缩压差值≥10 mm Hg 记录为 sIAD 增加。收缩压（SBP）较高的手臂被指定为参考臂。我们的研究结果表明，全组的 sIAD 患病率为 18.1%。与未受影响的手臂相比，瘫痪手臂的平均 SBP 水平（133.6±18.4 vs. 133.8±18.4 mm Hg，NS）和 DBP 水平（77.8±11.5 vs. 77.2±10.9 mm Hg，NS）相似。参照臂 SBP 值的高血压或未控制高血压检出率高于未受影响臂（41.8% 对 36.3%）。结论是，在康复期的脑卒中后偏瘫患者中，sIAD ≥10 mmHg 的发生率相对较高，使用非受影响臂而非未受影响臂测量血压可诱导高血压的正确检测。

引用次数: 0

Spot urinary sodium-to-potassium ratio is associated with blood pressure levels in healthy adolescents: the Wakayama Study 斑尿钠钾比值与健康青少年的血压水平有关：和歌山研究

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2023-12-19 DOI: 10.1038/s41371-023-00883-1

Yan Zhang, Nobuyuki Miyai, Miyoko Utsumi, Kazuhisa Miyashita, Mikio Arita

The spot urinary sodium-to-potassium (Na/K) ratio is a simple measure of salt loading and has been shown to be associated with elevated blood pressure (BP) in middle-aged and older adults. This study aimed to evaluate the association between the spot urinary Na/K ratio and BP in 457 healthy adolescents aged 12–15 years in a school-based setting. The mean urinary Na/K ratio was 4.99 ± 2.76, and no significant difference was found between the boys and girls. When the participants were stratified based on urinary Na/K ratio quartile, age- and sex-adjusted systolic and diastolic BP gradually increased as Na/K ratio increased (systolic BP: 106.1, 106.9, 108.2, and 111.5 mmHg, Ptrend < 0.001; diastolic BP: 62.0, 62.4, 63.1, 64.3 mmHg, Ptrend = 0.022). The systolic and diastolic BP were more closely associated with urinary Na/K ratio than with Na and K levels, as well as estimated daily salt intake. In the multiple regression analysis, the urinary Na/K ratio was significantly associated with systolic BP (β = 0.144, P < 0.001) and diastolic BP (β = 0.114, P = 0.015) independent of potential confounding factors. An additional subgroup analysis revealed that the BP of the group with both high salt intake (≥8.5 g/day) and high Na/K ratio (≥6.60) was significantly higher than that of the group with high salt intake alone (systolic BP, 115.0 vs. 109.1 mmHg, P < 0.001; diastolic BP, 66.0 vs. 62.5 mmHg, P = 0.017). These results suggest that the urinary Na/K ratio is associated with BP levels in healthy adolescents and may be useful for assessing salt loading and its effects on BP elevation.

定点尿钠钾（Na/K）比值是盐负荷的一种简单测量方法，已被证明与中老年人血压（BP）升高有关。本研究旨在评估学校环境中 457 名 12-15 岁健康青少年的定点尿液 Na/K 比值与血压之间的关系。尿液 Na/K 比值的平均值为 4.99 ± 2.76，男孩和女孩之间无明显差异。根据尿液 Na/K 比值四分位数对参与者进行分层，年龄和性别调整后的收缩压和舒张压随着 Na/K 比值的增加而逐渐升高（收缩压：106.1、106.9、108.2 和 111.5 mmHg，Ptrend < 0.001；舒张压：62.0、62.4、63.1 和 64.3 mmHg，Ptrend = 0.022）。收缩压和舒张压与尿液中 Na/K 比值的关系比与 Na 和 K 含量以及估计的每日盐摄入量的关系更为密切。在多元回归分析中，尿液 Na/K 比值与收缩压（β = 0.144，P < 0.001）和舒张压（β = 0.114，P = 0.015）显著相关，不受潜在混杂因素的影响。另一项亚组分析显示，高盐摄入量组（≥8.5 克/天）和高 Na/K 比值组（≥6.60）的血压明显高于单纯高盐摄入量组（收缩压，115.0 vs. 109.1 mmHg，P < 0.001；舒张压，66.0 vs. 62.5 mmHg，P = 0.017）。这些结果表明，尿液 Na/K 比值与健康青少年的血压水平有关，可用于评估盐负荷及其对血压升高的影响。

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引用次数: 0

The association of ideal cardiovascular health metrics and incident hypertension among an urban population of Iran: a decade follow-up in Tehran Lipid and Glucose Study 伊朗城市人口中理想的心血管健康指标与高血压发病率之间的关系：德黑兰血脂和血糖研究的十年跟踪调查

IF 2.7 4区医学 Q2 Medicine

Journal of Human Hypertension

Pub Date : 2023-12-18 DOI: 10.1038/s41371-023-00881-3

Fatemeh Rahmani, Samaneh Asgari, Fereidoun Azizi, Farzad Hadaegh

We aimed to determine the association between ideal cardiovascular health metrics (ICVHM) and the incidence of hypertension among Iranian adults. The study population included 5409 Iranian adults aged ≥20 years (2088 men) without hypertension (applying the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline) at baseline. The ICVHM was defined according to the AHA’s 2020 impact goals, excluding total cholesterol was replaced by non-HDL cholesterol (non-HDL-C). Multivariable Cox proportional hazards regression analysis was done to estimate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. During a median 8.5-year follow-up, 2972 new cases of hypertension were identified (men: 1,287). Non-HDL-C < 130 mg/dL in men [HR (95% CI): 0.75(0.65–0.86)] and fasting plasma glucose(FPG) < 100 mg/dL in women[HR (95% CI): 0.79(0.64–0.97)], and among both genders, being normal/overweigth status (compared to obese) and blood pressure <120/80 mmHg were associated with a lower risk for hypertension. Additionally, in both gender, a 1-point increase in the number of global ICVHM decreased the risk of hypertension by more than 10%, and having ≥5 vs. <2 ICVHM, were associated with a lower risk of hypertension by 30% (all p values < 0.05). Applying the JNC 7 guideline, the association between ICVHM, with incident hypertension, were generally similar. Having a higher number of ICVHM was associated with a lower risk of incident hypertension, using both 2017 ACC/AHA and JNC 7 guidelines, mostly attributable to keeping the ideal status of body mass index, non-HDL-C, and FPG.

我们旨在确定伊朗成年人理想心血管健康指标（ICVHM）与高血压发病率之间的关联。研究人群包括 5409 名年龄≥20 岁的伊朗成年人（2088 名男性），他们基线时没有高血压（采用 2017 年美国心脏病学会 (ACC)/ 美国心脏协会 (AHA) 指南）。ICVHM是根据AHA的2020年影响目标定义的，不包括总胆固醇被非高密度脂蛋白胆固醇（non-HDL-C）取代。多变量考克斯比例危险回归分析估算了连续变量和分类变量 ICVHM 的危险比 (HRs)。在中位 8.5 年的随访期间，共发现 2972 例新的高血压病例（男性：1287 例）。男性非高密度脂蛋白胆固醇为 130 毫克/分升[HR (95% CI)：0.75(0.65-0.86)]，女性空腹血浆葡萄糖为 100 毫克/分升[HR (95% CI)：0.79(0.64-0.97)]，在男女两性中，体重正常/超重（与肥胖相比）和血压为 120/80 毫米汞柱与较低的高血压风险有关。此外，在男女两性中，全球 ICVHM 的数量每增加 1 个点，患高血压的风险就会降低 10%以上；ICVHM ≥5 与 <2 相比，患高血压的风险降低 30%（所有 p 值均为 <0.05）。根据 JNC 7 指南，ICVHM 与高血压发病率之间的关系大致相似。采用2017 ACC/AHA和JNC 7指南，拥有较多的ICVHM与较低的高血压发病风险有关，这主要归因于保持理想的体重指数、非高密度脂蛋白胆固醇和脂蛋白胆固醇。

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引用次数: 0