■高血压患者多久可以达到正常血压(BP)的缓解(即,<140/90mmHg)在没有抗高血压药物的情况下,这对高血压的管理很重要,仍然很大程度上未知。这项观察性研究旨在调查未服用抗高血压药物的老年高血压患者的BP变化,并初步检查在这种情况下观察到的从高血压到正常BP的缓解是否与心血管疾病(CVD)的风险降低有关。
■2760名33-99岁的参与者(中位数60岁,四分位54-68年),来自健康与退休研究(2006年至2018年)和英国老龄化纵向研究(1998年至2016年),没有严重心血管疾病的人,是高血压,并且在基线血压测量时没有服用抗高血压药物,至少有一次随访血压测量,之前没有服用抗高血压药物,被纳入分析。主要结果是在最后一波测量时达到高血压缓解的患者比例。
■在6年的中位随访期间,52%的参与者显示收缩压降低≥6mmHg,舒张压降低≥3mmHg60%。1171名参与者(42%,95%CI:41-44%)在最后一次测量时达到缓解,到那时,67%的人,43%,29%的人保持正常血压状态约4年、8年和12年,分别。旨在检查机会和偏见的影响的各种补充分析产生了类似的结果。初步分析显示,基线时不吸烟,在随访期间达到正常的体重指数,在随访期间戒酒,其中,与高血压的缓解有关。与保持高血压的参与者相比,获得缓解的患者的CVD风险较低(校正风险比0.66,95%CI:0.47~0.92).
■在许多本研究人群中,在诊断后的最初几年,高血压可以在没有药物治疗干预的情况下逆转。这一发现可能对高血压的更个性化管理有影响。有必要进一步研究以确定预测此类高血压缓解的因素或算法。
■香港中文大学(7106452;7105959),深圳市科技计划项目(KQTD20190929172835662),中国科学院战略优先研究计划(XDB38040200),国家老龄研究所(R01AG017644;NIAU01AG009740)。
UNASSIGNED: How often hypertensive patients could achieve remission to normal blood pressure (BP) (i.e., <140/90 mmHg) in the absence of antihypertensive drugs, which is important for the management of hypertension, remains largely unknown. This observational study aimed to investigate the change of BP in older adults with hypertension who did not take antihypertensive drugs and preliminarily examine whether the remission from hypertension to normal BP observed in this setting was associated with lower risk of cardiovascular disease (CVD).
UNASSIGNED: 2760 participants aged 33-99 years (median 60 years, interquartile 54-68 years) from the Health and Retirement Study (wave 2006 to wave 2018) and the English Longitudinal Study of Ageing (wave 1998 to wave 2016), who had no major CVD, were hypertensive, and were not on antihypertensive drugs at the time of baseline BP measurement, and had at least one follow-up BP measurement before which no antihypertensive drugs were taken, were included for analysis. The main outcome was the proportion of patients who achieved remission of hypertension at the last wave of measurement.
UNASSIGNED: During a median follow-up of six years, 52% of the participants showed a reduction of ≥6 mmHg in systolic BP and 60% a reduction of ≥3 mmHg in diastolic BP. 1171 participants (42%, 95% CI: 41-44%) achieved remission at the last measurement, and by that time 67%, 43%, and 29% of them had maintained the normotensive state for around 4, 8, and 12 years, respectively. Various supplementary analyses that aimed to examine the impact of chance and bias yielded similar results. Preliminary analyses showed that being non-smokers at baseline, achieving a normal body mass index during follow-up, and quitting alcohol drinking during follow-up, among others, were associated with the remission of hypertension. Compared with the participants who remained hypertensive, those who achieved remission had a lower CVD risk (adjusted hazard ratio 0.66, 95% CI: 0.47-0.92).
UNASSIGNED: In many of this study population, hypertension could be reversed without the intervention of drug treatment in the first few years after diagnosis. This finding may have implications for more individualized management of hypertension. Further studies to identify the factors or algorithms predictive of such hypertension remission are warranted.
UNASSIGNED: The Chinese University of Hong Kong (7106452; 7105959),Shenzhen Science and Technology Program (KQTD20190929172835662), Strategic Priority Research Program of Chinese Academy of Sciences (XDB 38040200), National Institute on Aging (R01AG017644; NIA U01AG009740).