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非裔美国人肾脏疾病队列研究中左心室肥厚的患病率及其相关因素

Prevalence and correlates of left ventricular hypertrophy in the African American Study of Kidney Disease Cohort Study.

作者信息

Peterson Gail E, de Backer Tine, Gabriel Avril, Ilic Vladimir, Vagaonescu Tudor, Appel Lawrence J, Contreras Gabriel, Kendrick Cindy, Rostand Stephen, Phillips Robert A

机构信息

Division of Cardiology, University of Texas Southwestern Medical Center, 5909 Harry Hines Blvd, HA9.133, Dallas, TX 75235-9047, USA.

出版信息

Hypertension. 2007 Dec;50(6):1033-9. doi: 10.1161/HYPERTENSIONAHA.107.090613. Epub 2007 Oct 29.

Abstract

African Americans with hypertensive renal disease represent a high-risk population for cardiovascular events. Although left ventricular hypertrophy is a strong predictor of adverse cardiac outcome, the prevalence and associated factors of left ventricular hypertrophy in this patient population are not well described. The African American Study of Kidney Disease Cohort Study is a prospective, observational study that is an extension of the African American Study of Kidney Disease randomized clinical trial that was conducted from 1994 to 2001 in African Americans with hypertension and mild-to-moderate renal dysfunction. Echocardiograms and 24-hour ambulatory blood pressure monitoring were performed at the baseline visit of the cohort. Of 691 patients enrolled in the cohort study, 599 patients had interpretable baseline echocardiograms and ambulatory blood pressure data. Left ventricular hypertrophy was defined using a cut point for left ventricular mass index >49.2 g/m(2.7) in men and >46.7 m/m(2.7) in women. The majority of patients had left ventricular hypertrophy (66.7% of men and 73.9% of women). In a multiple regression analysis, higher average day and nighttime systolic blood pressure, younger age, and lower predicted glomerular filtration rate were associated with left ventricular hypertrophy, but albuminuria was not. These data demonstrate a striking prevalence of left ventricular hypertrophy in the African American Study of Kidney Disease Cohort and identify potential targets for prevention and therapeutic intervention in this high-risk patient population.

摘要

患有高血压肾病的非裔美国人是心血管事件的高危人群。尽管左心室肥厚是不良心脏结局的有力预测指标,但该患者群体中左心室肥厚的患病率及相关因素尚未得到充分描述。非裔美国人肾病队列研究是一项前瞻性观察性研究,它是1994年至2001年针对患有高血压和轻至中度肾功能不全的非裔美国人进行的非裔美国人肾病随机临床试验的扩展。在队列的基线访视时进行了超声心动图检查和24小时动态血压监测。在队列研究中登记的691名患者中,599名患者有可解释的基线超声心动图和动态血压数据。左心室肥厚的定义为男性左心室质量指数>49.2 g/m(2.7),女性>46.7 m/m(2.7)。大多数患者存在左心室肥厚(男性为66.7%,女性为73.9%)。在多元回归分析中,较高的日间和夜间平均收缩压、较年轻的年龄以及较低的预测肾小球滤过率与左心室肥厚相关,但蛋白尿与之无关。这些数据表明,在非裔美国人肾病队列中左心室肥厚的患病率惊人,并确定了该高危患者群体预防和治疗干预的潜在靶点。

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