Søraas Camilla L, Wachtell Kristian, Okin Peter M, Dahlöf Björn, Devereux Richard B, Tønnessen Theis, Kjeldsen Sverre E, Olsen Michael H
Oslo University Hospital, Ullevaal, Oslo, Norway.
Blood Press. 2010 Jun;19(3):145-51. doi: 10.3109/08037051.2010.481812.
Regression of left ventricular (LV) hypertrophy and albuminuria in hypertension has previously been shown to reduce clinical cardiovascular events and death. We aimed to investigate the associations of regression of electrocardiographic (ECG) LV hypertrophy and albuminuria with the incidence of revascularization.
In 9193 hypertensive patients included in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study, we measured urine albumin/creatinine ratio (UACR), LV hypertrophy by electrocardiography, serum high-density lipoprotein (HDL) cholesterol, and blood pressure after 2 weeks of placebo treatment and yearly during 5 years of anti-hypertensive treatment with either an atenolol- or a losartan-based regimen. The incidence of coronary and peripheral revascularization was recorded.
In Cox regression analyses adjusted for treatment allocation and continent, high time-varying Sokolow-Lyon voltage (hazard ratio [HR]=1.01 [1.00-1.02], p=0.01), but not time-varying Cornell product or UACR, predicted coronary revascularization together with low time-varying HDL-cholesterol, low time-varying pulse pressure, high Framingham risk score and history of angina pectoris. Adjusted for treatment allocation and continent, high time-varying Sokolow-Lyon voltage (HR=1.01 [1.00-1.03], p=0.02), but not time-varying Cornell product or UACR, predicted peripheral revascularization together with high time-varying pulse pressure, high Framingham risk score, history of peripheral vascular disease and prior myocardial infarction.
Higher Sokolow-Lyon voltage during antihypertensive treatment, but not UACR or the Cornell voltage-duration product, was independently associated with higher incidence of coronary as well as peripheral revascularization.
先前已表明，高血压患者左心室（LV）肥厚和蛋白尿的消退可减少临床心血管事件和死亡。我们旨在研究心电图（ECG）左心室肥厚和蛋白尿的消退与血运重建发生率之间的关联。
在“氯沙坦干预降低高血压终点研究（LIFE）”纳入的9193例高血压患者中，我们在安慰剂治疗2周后以及使用阿替洛尔或氯沙坦为基础的治疗方案进行5年抗高血压治疗期间每年测量尿白蛋白/肌酐比值（UACR）、通过心电图测量左心室肥厚、血清高密度脂蛋白（HDL）胆固醇和血压。记录冠状动脉和外周血运重建的发生率。
在根据治疗分配和大洲进行校正的Cox回归分析中，高时变索科洛夫-里昂电压（风险比[HR]=1.01[1.00 - 1.02]，p = 0.01），而非时变康奈尔乘积或UACR，与低时变HDL胆固醇、低时变脉压、高弗雷明汉风险评分和心绞痛病史一起预测冠状动脉血运重建。在根据治疗分配和大洲进行校正后，高时变索科洛夫-里昂电压（HR = 1.01[1.00 - 1.03]，p = 0.02），而非时变康奈尔乘积或UACR，与高时变脉压、高弗雷明汉风险评分、外周血管疾病史和既往心肌梗死一起预测外周血运重建。
抗高血压治疗期间较高的索科洛夫-里昂电压，而非UACR或康奈尔电压-时长乘积，与冠状动脉以及外周血运重建的较高发生率独立相关。
