Health Planning Center, Nihon University School of Medicine, Tokyo, Japan.
J Hum Hypertens. 2012 Jun;26(6):388-95. doi: 10.1038/jhh.2011.49. Epub 2011 May 19.
Dyslipidaemia is often associated with hypertension, and many clinical trials have shown that lipid-lowering therapy and strict blood pressure (BP) control are important for preventing cardiovascular disease (CVD). However, few reports describe the effect of statins on CVD occurrence in relation to long-term BP control. In the present analysis, we investigated the effects of baseline BP and follow-up BP control on the occurrence of CVD in patients enrolled in the MEGA Study. We investigated whether BP values provide more accurate prediction of the occurrence of CVD, including cerebrovascular disease/transischemic attack (CVA/TIA), and the effect of pravastatin on CVA/TIA. The risk for CVA/TIA and other CVD increased significantly (P≤0.001) as the severity of hypertension increased. In contrast, pravastatin reduced the onset of CVA/TIA, regardless of the BP controlled. The mean BP was a more accurate predictor of CVD than a one-time BP value. In patients with mild-to-moderate dyslipidaemia, elevated BP increases the risk for CVA/TIA and other CVD, and rigorous BP control was important for preventing CVD, in particular CVA/TIA. The 12-month mean BP is useful to avoid attenuation to determine the association between CVD and BP. Pravastatin prevented CVA/TIA, regardless of BP controlled.
血脂异常常与高血压相关,许多临床试验表明,降脂治疗和严格的血压(BP)控制对于预防心血管疾病(CVD)非常重要。然而,很少有报道描述他汀类药物对 CVD 发生与长期 BP 控制之间的关系的影响。在本分析中,我们研究了 MEGA 研究中纳入的患者的基线 BP 和随访 BP 控制对 CVD 发生的影响。我们研究了 BP 值是否可以更准确地预测 CVD 的发生,包括脑血管疾病/短暂性脑缺血发作(CVA/TIA),以及普伐他汀对 CVA/TIA 的影响。随着高血压严重程度的增加,CVA/TIA 和其他 CVD 的风险显著增加(P≤0.001)。相反,无论 BP 控制如何,普伐他汀均可降低 CVA/TIA 的发病。平均 BP 比单次 BP 值更能准确预测 CVD。在轻中度血脂异常患者中,升高的 BP 会增加 CVA/TIA 和其他 CVD 的风险,严格的 BP 控制对于预防 CVD,特别是 CVA/TIA 非常重要。12 个月的平均 BP 有助于避免衰减,以确定 CVD 和 BP 之间的关联。无论 BP 是否控制,普伐他汀均可预防 CVA/TIA。