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国际家庭血压与心血管结局数据库(IDHOCO):从基线特征到研究视角。

The International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO): moving from baseline characteristics to research perspectives.

机构信息

Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Turku, Finland.

出版信息

Hypertens Res. 2012 Nov;35(11):1072-9. doi: 10.1038/hr.2012.97. Epub 2012 Jul 5.

Abstract

The objective of this study is to construct an International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO). The main goal of this database is to determine outcome-based diagnostic thresholds for the self-measured home blood pressure (BP). Secondary objectives include investigating the predictive value of white-coat and masked hypertension, morning and evening BP, BP and heart rate variability, and the home arterial stiffness index. We also aim to determine an optimal schedule for home BP measurements that provides the most accurate risk stratification. Eligible studies are population-based, have fatal as well as nonfatal outcomes available for analysis, comply with ethical standards, and have been previously published in peer-reviewed journals. In a meta-analysis based on individual subject data, composite and cause-specific cardiovascular events will be related to various indexes derived by home BP measurement. The analyses will be stratified by a cohort and adjusted for the clinic BP and established cardiovascular risk factors. The database includes 6753 subjects from five cohorts recruited in Ohasama, Japan (n=2777); Finland (n=2075); Tsurugaya, Japan (n=836); Didima, Greece (n=665); and Montevideo, Uruguay (n=400). In these five cohorts, during a total of 62 106 person-years of follow-up (mean 9.2 years), 852 subjects died and 740 participants experienced a fatal or nonfatal cardiovascular event. IDHOCO provides a unique opportunity to investigate several hypotheses that could not reliably be studied in individual studies. The results of these analyses should be of help to clinicians involved in the management of patients with suspected or established hypertension.

摘要

本研究旨在构建一个国际家庭血压与心血管结局数据库(IDHOCO)。该数据库的主要目标是确定基于结局的自我测量家庭血压(BP)诊断阈值。次要目标包括研究白大衣高血压和隐蔽性高血压、晨晚间血压、BP 和心率变异性以及家庭动脉僵硬度指数的预测价值。我们还旨在确定家庭 BP 测量的最佳方案,以提供最准确的风险分层。符合条件的研究为基于人群的研究,具有可用于分析的致命和非致命结局,符合伦理标准,并已在同行评议期刊上发表。在基于个体受试者数据的荟萃分析中,复合和特定原因的心血管事件将与家庭 BP 测量得出的各种指标相关联。分析将按队列分层,并根据诊所 BP 和已确立的心血管危险因素进行调整。该数据库包括来自五个队列的 6753 名受试者,这些队列分别在日本大洗(n=2777)、芬兰(n=2075)、日本鹤贺(n=836)、希腊季季马(n=665)和乌拉圭蒙得维的亚(n=400)招募。在这些五个队列中,共随访 62106 人年(平均 9.2 年),852 名受试者死亡,740 名参与者发生致命或非致命心血管事件。IDHOCO 提供了一个独特的机会,可以研究在个体研究中无法可靠研究的几个假设。这些分析的结果应该对参与疑似或已确诊高血压患者管理的临床医生有所帮助。

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