Abstract:
Time in target range (TTR) and blood pressure variability (BPV) of systolic blood pressure (SBP) are independent risk factors for major adverse cardiovascular events (MACE) and all-cause mortality in hypertensive patients. However, the association of the combination of low TTR and high BPV of SBP with the risk of MACE and all-cause mortality is unclear. This study sought to investigate the combined effect of the TTR and BPV on the risk of MACE and all-cause mortality in patients with hypertension. A total of 11 496 hypertensive patients from the Kailuan cohort study were included in our study. All participants were divided into four groups according to their TTR and BPV levels. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident MACE and all-cause mortality. During a median follow-up of 5.64 years, 839 MACEs (included 99 cases of myocardial infarction, 591 cases of stroke, and 191 cases of heart failure) and 621 deaths occurred. Compared with the high-TTR and low-BPV group, the HRs (95% CI) of MACE and all-cause mortality were 1.309 (1.025-1.671) and 1.842 (1.373-2.473) for the high-TTR and high-BPV group, 1.692 (1.347-2.125) and 1.731 (1.298-2.309) for the low-TTR & low-BPV group, 2.132 (1.728-2.629) and 2.247 (1.722-2.932) for the low-TTR & high-BPV group. Our study suggests that the combination of low TTR and high BPV of SBP was associated with a higher risk of MACE and all-cause mortality in patients with hypertension.
摘要:
在目标范围内的时间(TTR)和收缩压(SBP)的血压变异性(BPV)是高血压患者主要不良心血管事件(MACE)和全因死亡的独立危险因素。然而,SBP低TTR和高BPV与MACE风险和全因死亡率的相关性尚不清楚.本研究旨在探讨TTR和BPV对高血压患者MACE风险和全因死亡率的综合影响。共有11496名来自开luan队列研究的高血压患者被纳入我们的研究。根据TTR和BPV水平将所有参与者分为四组。Cox比例风险回归模型用于计算事件MACE和全因死亡率的风险比(HR)和95%置信区间(CI)。在5.64年的中位随访期间,839例MACEs(包括99例心肌梗塞,591例中风,和191例心力衰竭)和621例死亡。与高TTR和低BPV组相比,高TTR和高BPV组的MACE和全因死亡率的HR(95%CI)分别为1.309(1.025-1.671)和1.842(1.373-2.473),低TTR和低BPV组的1.692(1.347-2.125)和1.731(1.298-2.309),低TTR和高BPV组的2.132(1.728-2.629)和2.247(1.722-2.932)。我们的研究表明,SBP的低TTR和高BPV的组合与高血压患者的MACE和全因死亡率的高风险相关。