PDF(Pubmed)
Abstract：
Central blood pressure confers cardiovascular risk prediction ability, but whether the association between central systolic blood pressure (cSBP) and cardiovascular endpoints is independent of peripheral systolic blood pressure (pSBP) remains controversial. This systematic review and meta-analysis aim to investigate the associations between cSBP and cardiovascular endpoints in models including and excluding pSBP, respectively. Observational studies assessing the risk of composite cardiovascular endpoints with baseline cSBP were searched in PubMed, Embase, Scopus, Web of Science, and Cochrane Library to May 31, 2022. Risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale, and random-effects models were used to pool estimates. Finally, 48 200 participants from 19 studies with a mean age of 59.0 ± 6.9 years were included. Per 10 mmHg increase of cSBP was associated with higher risk of composite cardiovascular outcomes (risk ratio [RR]: 1.14 [95%CI 1.08-1.19]) and cardiovascular death (RR: 1.18 [95%CI 1.08-1.30]), and the associations still existed after adjusting for pSBP (RR: 1.13 [95%CI 1.05-1.21] for composite cardiovascular endpoints; RR: 1.25 [95%CI 1.09-1.43] for cardiovascular death). In pSBP-unadjusted studies, increased cSBP was also associated with higher risk of all-cause mortality and stroke, but not in the pSBP-adjusted studies. Both cSBP and pSBP were similarly significantly associated with composite cardiovascular endpoints in models containing them separately and simultaneously. cSBP was significantly associated with cardiovascular events, independently of pSBP. Central or peripheral SBP could supplement cardiovascular risk assessment besides each other.
摘要：
中枢血压赋予心血管风险预测能力，但中心收缩压(cSBP)与心血管终点之间的关联是否独立于外周收缩压(pSBP)仍存在争议.本系统综述和荟萃分析旨在研究cSBP与心血管终点之间的关系，包括和不包括pSBP。分别。在PubMed中搜索了评估基线cSBP复合心血管终点风险的观察性研究，Embase,Scopus,WebofScience,和Cochrane图书馆至2022年5月31日。通过纽卡斯尔-渥太华质量评估量表评估偏倚风险，和随机效应模型被用来汇集估计。最后,纳入了来自19项研究的48200名参与者，平均年龄为59.0±6.9岁。cSBP每增加10mmHg与复合心血管结局（风险比[RR]：1.14[95CI1.08-1.19]）和心血管死亡（RR：1.18[95CI1.08-1.30]）的风险较高相关，校正pSBP后仍存在关联(对于复合心血管终点,RR:1.13[95CI1.05-1.21];对于心血管死亡,RR:1.25[95CI1.09-1.43]).在pSBP未调整的研究中，cSBP升高也与全因死亡率和卒中风险升高相关,但在pSBP校正研究中没有。在分别和同时含有cSBP和pSBP的模型中，cSBP和pSBP与复合心血管终点相似地显著相关。cSBP与心血管事件显著相关，独立于PSBP。中枢或外周SBP可以补充心血管风险评估。
